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General NPI Number Information
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NPI Number | 1508084609
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Entity Type | Organization
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Legal Business Name | DEERFIELD CENTER FOR DENTAL SPECIALTIES
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1800 W HILLSBORO BLVD #211
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1484
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Country | US
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Telephone | 954-427-4287
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Fax | 954-427-5540
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Provider Business Mailing Address
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Address Line | 1800 W HILLSBORO BLVD #211
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1484
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Country | US
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Telephone | 954-427-4287
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Fax | 954-427-5540
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JODI PONCE
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Credential |
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Telephone | 954-427-4287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 08490
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 15174
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 13518
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 14521
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License Number State | FL
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