Provider Demographics
NPI:1841321015
Name:GARY YANOWITZ DDS PA
Entity type:Organization
Organization Name:GARY YANOWITZ DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:YANOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-431-9500
Mailing Address - Street 1:1000 N HIATUS RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3097
Mailing Address - Country:US
Mailing Address - Phone:954-431-9500
Mailing Address - Fax:954-431-0317
Practice Address - Street 1:1000 N HIATUS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3097
Practice Address - Country:US
Practice Address - Phone:954-431-9500
Practice Address - Fax:954-431-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL76361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty