Provider Demographics
NPI:1487320024
Name:YISROLE NOSKOW DMD PALM CITY PA
Entity type:Organization
Organization Name:YISROLE NOSKOW DMD PALM CITY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:YISROEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSKOW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-409-6772
Mailing Address - Street 1:990 SE 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-9506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1151 SW 30TH ST STE C
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2985
Practice Address - Country:US
Practice Address - Phone:772-409-6772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty