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General NPI Number Information
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NPI Number | 1376798355
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL DENTAL TEAM, PA
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 5100 S DIXIE HWY STE 2
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-3240
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Country | US
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Telephone | 561-721-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 5100 S DIXIE HWY STE 2
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-3240
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Country | US
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Telephone | 561-721-2525
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. OLGA MARLENNE GALINDO
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Credential | DDS
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Telephone | 561-721-2525
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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 | DN 18296
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License Number State | FL
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