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General NPI Number Information
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NPI Number | 1538741392
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Entity Type | Individual
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Provider Name | DEANNA PANDOLFO DMD
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Gender | Female
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 685 ROYAL PALM BEACH BLVD STE 202
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-7642
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Country | US
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Telephone | 561-270-0209
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Fax |
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Provider Business Mailing Address
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Address Line | 685 ROYAL PALM BEACH BLVD STE 202
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-7642
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Country | US
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Telephone |
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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 | DN25510
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License Number State | FL
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