Provider Demographics
NPI:1063937878
Name:BOCA DENTAL ARTS PA
Entity type:Organization
Organization Name:BOCA DENTAL ARTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AXEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCGUFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-235-5424
Mailing Address - Street 1:20968 CERTOSA TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1638
Mailing Address - Country:US
Mailing Address - Phone:239-248-7443
Mailing Address - Fax:
Practice Address - Street 1:21073 POWERLINE RD STE 65
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2306
Practice Address - Country:US
Practice Address - Phone:561-235-5424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty