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General NPI Number Information
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NPI Number | 1255943163
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Entity Type | Organization
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Legal Business Name | OCEANSIDE GENTLE DENTISTRY, PLLC
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 2323 NE 26TH AVE STE 110
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1147
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Country | US
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Telephone | 754-238-1038
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Fax | 754-238-1030
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Provider Business Mailing Address
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Address Line | 3846 TREE TOP DR
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City | WESTON
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State | FL
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Zip | 33332-2139
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Country | US
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Telephone | 248-250-1507
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Fax |
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. NEHAL ALI
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Credential | DDS
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Telephone | 754-238-1038
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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 |
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License Number State |
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