MEDICARE: DELRAY FAMILY DENTISTRY 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
1	122300000X	Dentist

General Provider Information

NPI Number	:	1972722429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELRAY FAMILY DENTISTRY P.A.

Provider Business Mailing Address
First Line	:	4993 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3850
Country	:	US
Telephone Number	:	561-381-3100
Fax Number	:	561-381-3323

Provider Business Practice Location Address
First Line	:	4993 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3850
Country	:	US
Telephone Number	:	561-381-3100
Fax Number	:	561-381-3323

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SHARI GOLDSTEIN
Credential	:	D.D.S.
Telephone Number	:	561-381-3100

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	08/22/2020

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