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General NPI Number Information
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NPI Number | 1437660800
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Entity Type | Organization
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Legal Business Name | CORAL SPRINGS FAMILY ORTHODONTICS
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/12/2017
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Provider Practice Location Address
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Address Line | 1881 N UNIVERSITY DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8915
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Country | US
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Telephone | 954-393-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 NW 127TH WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-5446
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BLANCA ROJAS
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Credential |
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Telephone | 561-235-8315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN16107
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License Number State | FL
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