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General NPI Number Information
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NPI Number | 1558932608
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Entity Type | Organization
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Legal Business Name | IMPLANTATION DENTISTRY
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 1761 N UNIVERSITY DR
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City | PLANTATION
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State | FL
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Zip | 33322-4111
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Country | US
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Telephone | 954-990-5657
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Fax | 954-990-5689
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Provider Business Mailing Address
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Address Line | 1761 N UNIVERSITY DR
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City | PLANTATION
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State | FL
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Zip | 33322-4111
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Country | US
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Telephone | 954-990-5657
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Fax | 954-990-5689
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Authorized Official
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Title or Position | DMD/OWNER
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Name | EHAB MUSHARBASH
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Credential |
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Telephone | 904-652-5119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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