Provider Demographics
NPI:1023893039
Name:DENTAL ARTS OF BROWARD PA
Entity type:Organization
Organization Name:DENTAL ARTS OF BROWARD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:YURIXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-621-0732
Mailing Address - Street 1:3207 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7008
Mailing Address - Country:US
Mailing Address - Phone:954-979-1357
Mailing Address - Fax:
Practice Address - Street 1:3207 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7008
Practice Address - Country:US
Practice Address - Phone:954-979-1357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty