Provider Demographics
NPI:1962744102
Name:ROYZMAN, ANNA (DMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ROYZMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:ROYZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:12801 W SUNRISE BLVD
Mailing Address - Street 2:F222
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323
Mailing Address - Country:US
Mailing Address - Phone:954-846-7171
Mailing Address - Fax:
Practice Address - Street 1:12801 W SUNRISE BLVD
Practice Address - Street 2:F222
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-4020
Practice Address - Country:US
Practice Address - Phone:954-846-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist