=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700457694
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAUNDERS DENTAL, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2021
-----------------------------------------------------
Last Update Date | 07/01/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6180 W SAMPLE RD STE 109
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33067-3274
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-227-2718
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 560 SW 182ND WAY
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33029-4319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-309-2323
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGER
-----------------------------------------------------
Name | DR. MARIA P. SAUNDERS
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 954-309-2323
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------