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General NPI Number Information
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NPI Number | 1437667466
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Entity Type | Organization
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Legal Business Name | PLANTATION PALMS DENTAL P.A.
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Dates
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Enumeration Date | 01/11/2018
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Last Update Date | 01/11/2018
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Provider Practice Location Address
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Address Line | 1837 N PINE ISLAND RD
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City | PLANTATION
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State | FL
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Zip | 33322-5207
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Country | US
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Telephone | 954-350-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 1837 N PINE ISLAND RD
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City | PLANTATION
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State | FL
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Zip | 33322-5207
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Country | US
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Telephone | 954-350-0400
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. GABRIEL SHVETS
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Credential | DDS
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Telephone | 954-350-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN21909
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License Number State | FL
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