| Organization Name: | HEALTHY FAMILY DENTISTRY PA |
| NPI Number: | 1114255015 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MANUEL IGNACIO CRUCES (VICE PRESIDENT - DENTIST) |
| Mailing Address: | 5350 W Hillsboro Blvd Suite 201 Coconut Creek |
| State: | FL US |
| Postal Code: | 330734396 |
| Phone Number: | 9544780858 |
| Fax Number: | |
| NPI Enumeration Date: | 12/03/2009 |
| NPI Last Update Date: | 12/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN18716 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |