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General NPI Number Information
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NPI Number | 1477926541
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA SMILES
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 13590 JOG RD #1
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City | DELRAY BEACH
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State | FL
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Zip | 33446-3807
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Country | US
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Telephone | 561-499-1199
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Fax |
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Provider Business Mailing Address
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Address Line | 13590 JOG RD #1
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City | DELRAY BEACH
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State | FL
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Zip | 33446-3807
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Country | US
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Telephone | 561-499-1199
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ERNEST S ORPHANOS
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Credential | D.D.S
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Telephone | 561-477-7171
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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 | DN0013699
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License Number State | FL
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