Healthcare Provider Details
I. General information
NPI: 1750404133
Provider Name (Legal Business Name): DOLPHIN DENTAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2007
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10820 SEMINOLE BLVD
LARGO FL
33778-3336
US
IV. Provider business mailing address
10820 SEMINOLE BLVD
LARGO FL
33778-3336
US
V. Phone/Fax
- Phone: 727-393-9334
- Fax: 727-391-0134
- Phone: 727-393-9334
- Fax: 727-391-0134
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DN16051 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MAHER
RASHID
Title or Position: DENTIST
Credential: DMD
Phone: 727-393-9334