Sage Dental Of Hollywood, PLLC
Dentist in Hollywood, FL. Organization (NPI-2).
NPI number1083015697
StatusActive
Last updated in NPPESJun 8, 2023
Details
- NPI
- 1083015697
- Entity type
- Organization (NPI-2)
- Legal business name
- Sage Dental Of Hollywood, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 15, 2014
- Certification date
- Jun 8, 2023
- Last updated
- Jun 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
4461 Sheridan StHollywood, FL 33021-3513
Phone 954-966-6352 · Fax 561-431-8169
Mailing address
6600 Congress Ave Ste 150Boca Raton, FL 33487-1213
Phone 561-999-9650 · Fax 561-431-8169
Authorized official
Antonio Cruz
Chief Dental Director
5619999650
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