Healthcare Provider Details

I. General information

NPI: 1689712127
Provider Name (Legal Business Name): THE DENTIST PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2007
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27001 U.S. HIGHWAY 19 N SUITE 8520
CLEARWATER FL
33761
US

IV. Provider business mailing address

27001 U.S. HIGHWAY 19 N SUITE 8520
CLEARWATER FL
33761
US

V. Phone/Fax

Practice location:
  • Phone: 727-799-0650
  • Fax: 727-797-9273
Mailing address:
  • Phone: 727-799-0650
  • Fax: 727-797-9273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN 0008198
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN 0008198
License Number StateFL

VIII. Authorized Official

Name: DR. MURAD RASHID
Title or Position: GENERAL DENTIST
Credential: D.M.D.
Phone: 727-799-0650