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General NPI Number Information
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NPI Number | 1316104581
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Entity Type | Organization
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Legal Business Name | IVAN E. TERRERO DDS FL8 PA
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 1901 N FEDERAL HWY STE 350
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1000
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Country | US
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Telephone | 954-785-1102
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Fax |
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Provider Business Mailing Address
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Address Line | 555 WASHINGTON AVE
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City | MIAMI
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State | FL
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Zip | 33139-6607
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Country | US
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Telephone | 305-604-5707
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IVAN EDUARDO TERRERO
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Credential | DDS
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Telephone | 917-796-7624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN17477
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License Number State | FL
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