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General NPI Number Information
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NPI Number | 1093737363
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Entity Type | Individual
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Provider Name | PHILIP ANDREW PINE DDS
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1600 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6768
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Country | US
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Telephone | 954-782-1992
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Fax | 954-782-0425
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Provider Business Mailing Address
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Address Line | 50 S COMPASS DR
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-2006
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Country | US
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Telephone | 954-782-1992
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Fax | 954-782-0425
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | FL10129
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License Number State | FL
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