10D2197646 CLIA NUMBER - BIG BOCA SMILES LLC

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Laboratory Demographics

CLIA Number: 10D2197646

Facility Name: BIG BOCA SMILES LLC

Facility Address:
21301 POWERLINE RD STE 208
BOCA RATON, FL
ZIP 33433
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Facility Phone Number: 561 482-8000

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1689225997

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	10D2197646
LAB Type	Practitioner Other
Facility Name	BIG BOCA SMILES LLC
Street	21301 POWERLINE RD STE 208
City	BOCA RATON
State	FL
ZIP	33433
Phone	561 482-8000
CertificateType	4
CertificateEffectiveDate	10/27/2022
CertificateExpirationDate	10/26/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024