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General NPI Number Information
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NPI Number | 1265762421
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Entity Type | Organization
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Legal Business Name | NATURAL SMILE DENTISTRY
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Dates
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Enumeration Date | 01/10/2010
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Last Update Date | 09/06/2010
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Provider Practice Location Address
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Address Line | 470 COLUMBIA DR STE E101
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1949
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Country | US
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Telephone | 561-656-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 10436 TRIANON PL
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City | WELLINGTON
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State | FL
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Zip | 33449-8074
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Country | US
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Telephone | 561-596-7166
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE FERNANDO ALVAREZ
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Credential | DDS
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Telephone | 561-596-7166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18008
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License Number State | FL
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