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General NPI Number Information
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NPI Number | 1609352905
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Entity Type | Organization
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Legal Business Name | SHAPIRO FAMILY DENTISTRY OF FORT PIERCE PA
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | CORAL SQUARE SHOPPES 3006 US HIGHWAY 1 SUITE D2/D3
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City | FORT PIERCE
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State | FL
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Zip | 34982
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Country | US
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Telephone | 772-242-0053
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Fax | 772-242-0081
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Provider Business Mailing Address
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Address Line | 2247 PALM BEACH LAKES BLVD STE 105
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-3408
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Country | US
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Telephone | 561-254-2868
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Fax | 561-328-6217
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DARI SHAPIRO
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Credential | DDS
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Telephone | 561-254-2868
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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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