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General NPI Number Information
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NPI Number | 1295343697
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Entity Type | Organization
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Legal Business Name | SOMI DENTAL GROUP OF BOCA RATON, LLC
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 1590 NW 10TH AVE STE 301
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City | BOCA RATON
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State | FL
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Zip | 33486-1323
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Country | US
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Telephone | 53-953-4433
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Fax | 561-395-8353
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Provider Business Mailing Address
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Address Line | PO BOX 430587
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City | SOUTH MIAMI
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State | FL
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Zip | 33243-0587
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Country | US
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Telephone | 305-338-8876
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ARNALDO ANDRE LOPEZ
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Credential | DDS
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Telephone | 305-338-8876
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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 |
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License Number State |
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