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General NPI Number Information
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NPI Number | 1558795054
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Entity Type | Organization
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Legal Business Name | GISELE OLIVEIRA CORP
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 950 N FEDERAL HWY STE 202
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4315
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Country | US
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Telephone | 954-532-6637
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Fax |
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Provider Business Mailing Address
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Address Line | 950 N FEDERAL HWY STE 202
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4315
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Country | US
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Telephone | 954-532-6637
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GISELE OLIVEIRA
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Credential | D.M.D.
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Telephone | 954-532-6637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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