Healthcare Provider Details

I. General information

NPI: 1851772859
Provider Name (Legal Business Name): DENTAL HYGIENE CENTERS OF FLORIDA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 06/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11402 NW 41ST ST STE: 114
DORAL FL
33178-4859
US

IV. Provider business mailing address

11402 NW 41ST ST STE: 114
DORAL FL
33178-4859
US

V. Phone/Fax

Practice location:
  • Phone: 305-593-6520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN0010709
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDN0010709
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID ALLEN BENNETT
Title or Position: PRESIDENT
Credential: DDS
Phone: 305-593-6520