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General NPI Number Information
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NPI Number | 1922338011
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Entity Type | Organization
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Legal Business Name | FLORIDA DENTAL & DENTURE CTR. 111
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 2945 N AUSTRALIAN AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-4522
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Country | US
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Telephone | 561-844-0033
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Fax | 561-844-1486
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Provider Business Mailing Address
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Address Line | 2945 N AUSTRALIAN AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-4522
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Country | US
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Telephone | 561-844-0033
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Fax | 561-844-1486
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Authorized Official
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Title or Position | OWNER
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Name | DR. YVES SEMEAH
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Credential | D.S.
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Telephone | 561-844-0033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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