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General NPI Number Information
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NPI Number | 1497179725
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Entity Type | Organization
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Legal Business Name | CENTER FOR COMPLETE DENTISTRY OF PEMBROKE PINES
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 700 N HIATUS RD SUITE 102
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-5206
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Country | US
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Telephone | 954-392-1635
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Fax | 954-392-1637
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Provider Business Mailing Address
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Address Line | 700 N HIATUS RD SUITE 102
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-5206
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Country | US
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Telephone | 954-392-1635
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Fax | 954-392-1637
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Authorized Official
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Title or Position | DENTIST
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Name | ARUN K GARG
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Credential | DMD
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Telephone | 954-392-1635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | DN11076
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License Number State | FL
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