DR. Philip L Provenzale, DDS
NPI #1124240908 in Belle Glade, Florida
Provider Information
- NPI Number
- 1124240908
- Entity Type
- Individual
- Name
- DR. Philip L Provenzale, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- May 3, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 417 NW 16TH ST
- Address 2
- SUITE 8
- City
- Belle Glade
- State
- Florida
- ZIP Code
- 33430-2441
- Phone
- (561) 996-3700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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