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General NPI Number Information
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NPI Number | 1194238386
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Entity Type | Organization
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Legal Business Name | DENTAL DESIGNS GROUP PA
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 6600 COW PEN RD
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City | MIAMI LAKES
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State | FL
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Zip | 33014-7600
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Country | US
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Telephone | 305-823-7521
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 COW PEN RD
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City | MIAMI LAKES
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State | FL
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Zip | 33014-7600
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Country | US
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Telephone | 305-823-7521
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF INSURANCE OPERATIONS
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Name | MARTHA HARP
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Credential | PHR
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Telephone | 678-372-7358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN20996
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License Number State | FL
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