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General NPI Number Information
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NPI Number | 1124567821
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Entity Type | Organization
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Legal Business Name | B&R DENTAL FLORIDA CORPORATION
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 600 S PINE ISLAND RD SUITE 201
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City | PLANTATION
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State | FL
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Zip | 33324-3166
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Country | US
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Telephone | 954-812-9919
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Fax |
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Provider Business Mailing Address
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Address Line | 751 LEIGH PALM AVE
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City | PLANTATION
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State | FL
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Zip | 33324-8252
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Country | US
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Telephone | 954-812-9919
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANIA KASHLAN
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Credential | DDS
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Telephone | 954-812-9919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN18607
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License Number State | FL
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