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General NPI Number Information
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NPI Number | 1982180725
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Entity Type | Organization
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Legal Business Name | GENTLE TEETH OF CORALSPRINGS AND PARKLAND
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 5401 N UNIVERSITY DR STE 101
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4636
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Country | US
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Telephone | 954-344-3932
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Fax | 844-260-5713
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Provider Business Mailing Address
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Address Line | 5401 N UNIVERSITY DR STE 101
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4636
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Country | US
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Telephone | 954-344-3932
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Fax | 844-260-5713
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SYDNEE SAMUEL
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Credential |
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Telephone | 954-344-3932
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN17317
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License Number State | FL
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