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NPI Code Detail

MEDICARE: CRAIG SPODAK DMD PA

MEDICARE: CRAIG SPODAK DMD 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
11223G0001XGeneral Practice Dentistry14948FL

General Provider Information

NPI Number : 1285887679
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRAIG SPODAK DMD PA
Provider Business Mailing Address
First Line : 3911 WEST ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3902
Country : US
Telephone Number : 561-498-0050
Fax Number : 561-498-0841
Provider Business Practice Location Address
First Line : 3911 WEST ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3902
Country : US
Telephone Number : 561-498-0050
Fax Number : 561-498-0841
Authorized Official
Title or Position : PRESIDENT
Name : MR. CRAIG SPODAK
Credential : DMD
Telephone Number : 561-498-0050
Provider Enumeration Date : 10/29/2008
Last Update Date : 07/17/2014

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Directions to “CRAIG SPODAK DMD PA ” Practice Location

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