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General NPI Number Information
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NPI Number | 1285896159
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Entity Type | Organization
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Legal Business Name | PYG DENTAL MANAGEMENT
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 1600 N STATE ROAD 7 STE 400
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City | LAUDERHILL
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State | FL
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Zip | 33313-5853
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Country | US
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Telephone | 954-581-9228
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 N STATE ROAD 7 STE 400
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City | LAUDERHILL
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State | FL
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Zip | 33313-5853
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Country | US
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Telephone | 954-581-9228
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. PETER J GANGI
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Credential |
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Telephone | 954-581-9228
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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 | DN15530
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License Number State | FL
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