Provider Demographics
NPI:1144366220
Name:POLASKY, DAWN L (DDS)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:L
Last Name:POLASKY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 N FEDERAL HWY
Mailing Address - Street 2:109
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-229-2424
Mailing Address - Fax:954-229-2427
Practice Address - Street 1:6231 N FEDERAL HWY
Practice Address - Street 2:109
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1903
Practice Address - Country:US
Practice Address - Phone:954-229-2424
Practice Address - Fax:954-229-2427
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN173941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice