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NPI Code Detail

MEDICARE: AVS DENTAL LOUNGE PA

MEDICARE: AVS DENTAL LOUNGE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1003732157
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVS DENTAL LOUNGE PA
Provider Business Mailing Address
First Line : 7000 W PALMETTO PARK RD STE 504
Second Line :
City : BOCA RATON
State : FL
Zip : 33433-3425
Country : US
Telephone Number : 561-563-8404
Fax Number :
Provider Business Practice Location Address
First Line : 7000 W PALMETTO PARK RD STE 504
Second Line :
City : BOCA RATON
State : FL
Zip : 33433-3425
Country : US
Telephone Number : 561-563-8404
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : FILIBERTO JOSE HERDOCIA
Credential : DDS
Telephone Number : 561-563-8404
Provider Enumeration Date : 06/24/2026
Last Update Date : 06/24/2026

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Directions to “AVS DENTAL LOUNGE PA ” Practice Location

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