Tarpon River Dental, P.a.
NPI #1134762818 in Fort Lauderdale, Florida
Provider Information
- NPI Number
- 1134762818
- Entity Type
- Organization
- Organization Name
- Tarpon River Dental, P.a.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 24, 2019
- Last Updated
- Oct 24, 2019
Practice Location
- Address
- 416 SE 11TH CT
- City
- Fort Lauderdale
- State
- Florida
- ZIP Code
- 33316-1144
- Phone
- (954) 663-2582
Authorized Official
- Name
- DR. MARIEL PETRUK
- Title
- OWNER
- Phone
- (954) 663-2582
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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