Advanced Dentistry South Florida Sepcialists LLC

Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Delray Beach, FL

NPI 1003285339 · NPPES record last updated Sep 16, 2015

Key facts

NPI
1003285339
Entity type
Organization (NPI type 2)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
Legal business name
ADVANCED DENTISTRY SOUTH FLORIDA SEPCIALISTS LLC
Practice address
15340 Jog Rd Ste 100
Delray Beach, FL 33446-2170
Phone
(561) 495-2099
NPI assigned
Sep 16, 2015
Organization subpart
Yes
Parent organization (as reported)
RICHARD J STALLER DDS PA

Authorized official

Name
Kelli Carter Staller
Title
Practice Administrator
Phone
(561) 495-2099

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

National Provider Directory

Part of
Richard J Staller DDS PA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics
Group: 193200000X MULTI-SPECIALTY GROUP
1223E0200X
Periodontics
Group: 193200000X MULTI-SPECIALTY GROUP
1223P0300X
Oral and Maxillofacial Surgery (Dentist)
Group: 193200000X MULTI-SPECIALTY GROUP
1223S0112X Yes

Addresses

Primary practice location

15340 Jog Rd Ste 100
Delray Beach, FL 33446-2170

Mailing address

15340 Jog Rd Ste 100
Delray Beach, FL 33446-2170
Phone (561) 495-2099

Other providers in Delray Beach, FL

All providers in Delray Beach, FL · Oral and Maxillofacial Surgery (Dentist) in Florida

Sources for this page

Verify at the official NPI Registry.