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General NPI Number Information
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NPI Number | 1902023856
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Entity Type | Organization
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Legal Business Name | EMERALD HILLS DENTAL CENTER
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 3856 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3634
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Country | US
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Telephone | 954-963-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 3856 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3634
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Country | US
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Telephone | 954-963-3338
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DARREN SOW
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Credential | D.D.S.
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Telephone | 954-983-2450
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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 | 10639
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License Number State | FL
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