Provider Demographics
NPI:1316672553
Name:JANICE DEFELICE DMD PLLC
Entity type:Organization
Organization Name:JANICE DEFELICE DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ROUSSELLE
Authorized Official - Last Name:DEFELICE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-542-6644
Mailing Address - Street 1:226 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5436
Mailing Address - Country:US
Mailing Address - Phone:305-542-6644
Mailing Address - Fax:954-454-1901
Practice Address - Street 1:226 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5436
Practice Address - Country:US
Practice Address - Phone:954-454-3883
Practice Address - Fax:954-454-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental