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General NPI Number Information
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NPI Number | 1750390266
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Entity Type | Organization
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Legal Business Name | DENTAL DIAGNOSTIC SCANNING & IMAGING
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10305 NW 41ST ST SUITE #: 207
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City | DORAL
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State | FL
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Zip | 33178-2396
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Country | US
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Telephone | 305-513-8457
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Fax |
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Provider Business Mailing Address
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Address Line | 10305 NW 41ST ST SUITE #: 207
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City | DORAL
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State | FL
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Zip | 33178-2396
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Country | US
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Telephone | 305-513-8457
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | DR. DAVID ALLEN BENNETT
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Credential | DDS
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Telephone | 305-513-8457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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