MEDICARE: DR. DAVID SANTANA DMD

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	1223G0001X	General Practice Dentistry	DN21226	FL

General Provider Information

NPI Number	:	1700266657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SANTANA DMD

Provider Business Mailing Address
First Line	:	11665 NW 83RD WAY
Second Line	:
City	:	PARKLAND
State	:	FL
Zip	:	33076-3594
Country	:	US
Telephone Number	:	954-829-8276
Fax Number	:

Provider Business Practice Location Address
First Line	:	2820 N UNIVERSITY DRIVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065
Country	:	US
Telephone Number	:	954-775-0185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2015
Last Update Date	:	05/22/2019

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