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General NPI Number Information
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NPI Number | 1932389913
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Entity Type | Individual
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Provider Name | SANTIAGO P ROLDAN DMD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 1501 SE 23RD AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7507
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Country | US
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Telephone | 954-788-2388
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Fax | 954-785-3755
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Provider Business Mailing Address
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Address Line | 1501 SE 23RD AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7507
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Country | US
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Telephone | 954-788-2388
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Fax | 954-785-3755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN15793
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License Number State | FL
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