| Custom Crowns | |
|
5400 S University Dr Davie FL 33328-5312 | |
| (954) 947-0641 | |
| Not Available |
| Full Name | Custom Crowns |
|---|---|
| Speciality | Technician, Pathology - Medical Laboratory |
| Location | 5400 S University Dr, Davie, Florida |
| Authorized Official Name and Position | Tyshawn Martin (CEO) |
| Authorized Official Contact | 3057887779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Crowns 5202 Plunkett St Hollywood FL 33021-8023 Ph: (305) 788-7779 | Custom Crowns 5400 S University Dr Davie FL 33328-5312 Ph: (954) 947-0641 |
| NPI Number | 1538813910 |
|---|---|
| Provider Enumeration Date | 02/04/2022 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538813910 | NPI | - | NPPES |
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