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NPI Code Detail

MEDICARE: SAGE DENTAL OF POMPANO BEACH, P.A.

MEDICARE: SAGE DENTAL OF POMPANO BEACH, P.A.
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 DentistryDN6483FL

General Provider Information

NPI Number : 1477758191
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAGE DENTAL OF POMPANO BEACH, P.A.
Provider Business Mailing Address
First Line : 951 BROKEN SOUND PKWY
Second Line : SUITE 250
City : BOCA RATON
State : FL
Zip : 33487
Country : US
Telephone Number : 561-999-9650
Fax Number : 561-431-8169
Provider Business Practice Location Address
First Line : 1650 N FEDERAL HWY
Second Line : SUITE 105
City : POMPANO BEACH
State : FL
Zip : 33062-3200
Country : US
Telephone Number : 954-946-4867
Fax Number : 561-431-8169
Authorized Official
Title or Position : CHIEF DENTAL DIRECTOR
Name : DR. ANTONIO CRUZ
Credential : DDS
Telephone Number : 561-999-9650
Provider Enumeration Date : 06/21/2007
Last Update Date : 04/19/2017

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Directions to “SAGE DENTAL OF POMPANO BEACH, P.A. ” Practice Location

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