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General NPI Number Information
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NPI Number | 1518300888
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Entity Type | Individual
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Provider Name | DEBORA GOLDSCHMIEDT SHAPIRO D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 3301 COLLEGE AVE
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City | DAVIE
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State | FL
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Zip | 33314-7796
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Country | US
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Telephone | 954-262-1789
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Fax |
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Provider Business Mailing Address
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Address Line | 3721 N 53RD AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33021-2204
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Country | US
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Telephone | 972-896-1646
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN22505
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License Number State | FL
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