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General NPI Number Information
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NPI Number | 1174927586
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Entity Type | Organization
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Legal Business Name | PREMIER DENTISTRY, INC.
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 1501 PRESIDENTIAL WAY SUITE 15
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-1800
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Country | US
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Telephone | 561-686-2077
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Fax | 561-686-2257
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Provider Business Mailing Address
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Address Line | 1501 PRESIDENTIAL WAY SUITE 15
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-1800
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Country | US
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Telephone | 561-686-2077
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Fax | 561-686-2257
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DANIEL MARK CASEL
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Credential | DMD
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Telephone | 561-686-2077
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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 |
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License Number State |
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