Provider Demographics
NPI:1215108022
Name:EDWARD W METZGAR JR. D.D.S.P.A.
Entity type:Organization
Organization Name:EDWARD W METZGAR JR. D.D.S.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:METZGAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-345-7592
Mailing Address - Street 1:1265 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8313
Mailing Address - Country:US
Mailing Address - Phone:954-345-7592
Mailing Address - Fax:954-345-2585
Practice Address - Street 1:1265 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8313
Practice Address - Country:US
Practice Address - Phone:954-345-7592
Practice Address - Fax:954-345-2585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty