Broward Periodontics PA

NPI #1639624539 in Ft Lauderdale, Florida

Provider Information

NPI Number: 1639624539
Entity Type: Organization
Organization Name: Broward Periodontics PA
Primary Specialty: Dentist
Enumeration Date: Aug 20, 2016
Last Updated: Aug 20, 2016

Practice Location

Address: 1027 SE 17TH ST
City: Ft Lauderdale
State: Florida
ZIP Code: 33316-2116
Phone: (954) 916-7664

Authorized Official

Name: DR. CHRISTOPHER DETURE, DMD
Title: DOCTOR/OWNER
Phone: (954) 916-7664

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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