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General NPI Number Information
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NPI Number | 1831467273
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Entity Type | Organization
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Legal Business Name | ASSEFF DENTAL LLC
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 3800 S OCEAN DR STE 241
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City | HOLLYWOOD
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State | FL
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Zip | 33019-2927
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Country | US
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Telephone | 954-456-2678
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Fax | 954-456-2711
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Provider Business Mailing Address
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Address Line | 3800 S OCEAN DR STE 241
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City | HOLLYWOOD
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State | FL
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Zip | 33019-2927
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Country | US
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Telephone | 954-456-2678
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Fax | 954-456-2711
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREA ASSEFF
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Credential | DMD
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Telephone | 954-456-2678
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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 | 3504
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17067
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License Number State | FL
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