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General NPI Number Information
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NPI Number | 1578949426
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Entity Type | Organization
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Legal Business Name | PERETZ JOBLOVE PERETZ DDS PA
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 4801 HOLLYWOOD BLVD SUITE A
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6545
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Country | US
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Telephone | 954-981-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 HOLLYWOOD BLVD SUITE A
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6545
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Country | US
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Telephone | 954-981-4500
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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. DAVID ALAN PERETZ
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Credential | DMD
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Telephone | 954-981-4500
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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 | DN10594
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License Number State | FL
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