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General NPI Number Information
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NPI Number | 1841645249
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Entity Type | Organization
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Legal Business Name | SETH D. POMERANTZ, DMD, PA
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 8201B N PINE ISLAND RD
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City | TAMARAC
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State | FL
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Zip | 33321-1500
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Country | US
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Telephone | 954-726-4511
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Fax | 954-726-5248
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Provider Business Mailing Address
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Address Line | 8201B N PINE ISLAND RD
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City | TAMARAC
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State | FL
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Zip | 33321-1500
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Country | US
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Telephone | 954-726-4511
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Fax | 954-726-5248
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Authorized Official
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Title or Position | OWNER
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Name | DR. SETH D. POMERANTZ
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Credential | DMD
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Telephone | 954-726-4511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17459
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 11264
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14357
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License Number State | FL
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