MEDICARE: EXCLUSIVE DENTAL CARE GROUP OF MARGATE, LLC

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
1	122300000X	Dentist	DN13937	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164977823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCLUSIVE DENTAL CARE GROUP OF MARGATE, LLC

Provider Business Mailing Address
First Line	:	5404 W ATLANTIC BLVD
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5209
Country	:	US
Telephone Number	:	954-974-4400
Fax Number	:	954-974-4402

Provider Business Practice Location Address
First Line	:	5404 W ATLANTIC BLVD
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5209
Country	:	US
Telephone Number	:	954-974-4400
Fax Number	:	954-974-4402

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CELIA FIGUEROA
Credential	:	DDS
Telephone Number	:	954-974-4400

Provider Enumeration Date	:	08/23/2016
Last Update Date	:	08/23/2016

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