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General NPI Number Information
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NPI Number | 1780376426
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Entity Type | Organization
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Legal Business Name | DEYAB DDS PLLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 1034 GATEWAY BLVD STE 101
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8360
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Country | US
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Telephone | 561-249-2585
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Fax | 561-318-8040
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Provider Business Mailing Address
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Address Line | 1034 GATEWAY BLVD STE 101
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8360
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Country | US
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Telephone | 561-249-2585
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Fax | 561-318-8040
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIM DEYAB
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Credential | DDS
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Telephone | 561-249-2585
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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 |
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License Number State |
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