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General NPI Number Information
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NPI Number | 1710798426
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Entity Type | Organization
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Legal Business Name | KIDS CARE DENTAL AND ORTHODONTICS OF EAST COMMERCIAL, INC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 2633 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4135
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Country | US
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Telephone | 954-632-8171
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Fax | 954-432-6716
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Provider Business Mailing Address
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Address Line | 10794 PINES BLVD STE 101
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3920
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Country | US
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Telephone | 954-632-8171
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Fax | 954-432-6716
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. NIGEL GRANDISON
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Credential | DMS
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Telephone | 954-326-2947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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