Provider Demographics
NPI:1396329314
Name:SAWGRASS GENTLE DENTISTRY
Entity type:Organization
Organization Name:SAWGRASS GENTLE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COTY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPPACCIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-251-4849
Mailing Address - Street 1:13713 W SUNRISE BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3213
Mailing Address - Country:US
Mailing Address - Phone:954-251-4849
Mailing Address - Fax:954-251-0870
Practice Address - Street 1:13713 W SUNRISE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3213
Practice Address - Country:US
Practice Address - Phone:954-251-4849
Practice Address - Fax:954-251-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty