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General NPI Number Information
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NPI Number | 1912279654
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL SOLUTIONS OF SOUTH FLORIDA
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 5054 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8129
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Country | US
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Telephone | 561-498-3182
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Fax | 561-498-9677
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Provider Business Mailing Address
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Address Line | 5054 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8129
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Country | US
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Telephone | 561-498-3182
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Fax | 561-498-9677
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD HOWARD HARRIS
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Credential | D.M.D.
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Telephone | 561-498-3182
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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 | DN12508
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License Number State | FL
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