Provider Demographics
NPI:1225838238
Name:MICHAEL R DUBNICK DMD PA
Entity type:Organization
Organization Name:MICHAEL R DUBNICK DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUBNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-487-5757
Mailing Address - Street 1:9291 GLADES RD STE 303
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3959
Mailing Address - Country:US
Mailing Address - Phone:561-487-5757
Mailing Address - Fax:561-487-7935
Practice Address - Street 1:9291 GLADES RD STE 303
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3959
Practice Address - Country:US
Practice Address - Phone:561-487-5757
Practice Address - Fax:561-487-7935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty