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General NPI Number Information
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NPI Number | 1508439050
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Entity Type | Organization
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Legal Business Name | CMA DENTAL PLLC
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 9497 OLD PINE RD
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City | BOCA RATON
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State | FL
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Zip | 33428-3055
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Country | US
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Telephone | 305-336-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 9497 OLD PINE RD
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City | BOCA RATON
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State | FL
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Zip | 33428-3055
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Country | US
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Telephone | 305-336-4515
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | SEAN SHKOLNIK
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Credential | DDS
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Telephone | 305-336-4515
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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 |
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License Number State |
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