MEDICARE: ALL DENTAL SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN14149	FL

General Provider Information

NPI Number	:	1003022393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL DENTAL SERVICES INC.

Provider Business Mailing Address
First Line	:	2544 VAN BUREN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4935
Country	:	US
Telephone Number	:	954-927-1717
Fax Number	:	954-925-5871

Provider Business Practice Location Address
First Line	:	2544 VAN BUREN ST.
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6711
Country	:	US
Telephone Number	:	954-927-1717
Fax Number	:	954-925-5871

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GERMAN SANTANA
Credential	:	DDS
Telephone Number	:	954-927-1717

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	04/10/2013

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