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General NPI Number Information
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NPI Number | 1851893424
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Entity Type | Organization
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Legal Business Name | BOYNTON IMPLANT AND COSMETIC SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | 3695 W BOYNTON BEACH BLVD STE 5
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4516
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Country | US
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Telephone | 561-734-0505
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Fax | 561-734-0506
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Provider Business Mailing Address
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Address Line | 3695 W BOYNTON BEACH BLVD STE 5
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4516
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Country | US
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Telephone | 561-734-0505
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Fax | 561-734-0506
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALICIA TORO
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Credential | DDS
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Telephone | 561-734-0505
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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 | DN21781
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License Number State | FL
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