Broward Mall Dental, PA
NPI #1376766568 in Plantation, Florida
Provider Information
- NPI Number
- 1376766568
- Entity Type
- Organization
- Organization Name
- Broward Mall Dental, PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 10, 2007
- Last Updated
- Dec 3, 2018
Practice Location
- Address
- 8000 W BROWARD BLVD STE 834
- City
- Plantation
- State
- Florida
- ZIP Code
- 33388-0023
- Phone
- (954) 476-0802
Authorized Official
- Name
- ROSTISLAV KRASNOV, DDS
- Title
- OWNER
- Phone
- (954) 476-0802
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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