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General NPI Number Information
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NPI Number | 1548425283
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Entity Type | Organization
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Legal Business Name | DR. I. TERRERO, PA
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 5351 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3342
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Country | US
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Telephone | 954-963-8282
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Fax |
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Provider Business Mailing Address
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Address Line | 5351 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3342
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Country | US
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Telephone | 954-963-8282
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IVAN EDUARDO TERRERO
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Credential | DDS
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Telephone | 954-963-8282
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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 | DN17477
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License Number State | FL
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