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General NPI Number Information
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NPI Number | 1639475833
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Entity Type | Organization
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Legal Business Name | PREMIERE DENTAL CARE PL
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 600 SOUTH DIXIE HIGHWAY #105
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City | WEST PALM BEACH
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State | FL
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Zip | 33401
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Country | US
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Telephone | 561-820-8898
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Fax | 561-366-1788
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Provider Business Mailing Address
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Address Line | 600 S DIXIE HIGHWAY SUITE 105
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City | WEST PALM BEACH
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State | FL
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Zip | 33401
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Country | US
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Telephone | 561-820-8898
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Fax | 561-366-1788
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIN WAI HUI
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Credential | DMD
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Telephone | 561-820-8898
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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 | DN12723
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License Number State | FL
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