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General NPI Number Information
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NPI Number | 1972807204
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Entity Type | Individual
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Provider Name | INGRID JOHANNA ROMERO D.M.D
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Gender | Female
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 13910 S JOG RD STE 103
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City | DELRAY BEACH
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State | FL
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Zip | 33446-5908
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Country | US
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Telephone | 561-501-5759
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Fax |
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Provider Business Mailing Address
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Address Line | 2645 FILLMORE ST
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4327
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Country | US
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Telephone | 305-335-9535
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Fax |
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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 | DN19252
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License Number State | FL
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