Provider Demographics
NPI:1043328024
Name:NBW, D.D.S., INC.
Entity Type:Organization
Organization Name:NBW, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:B
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:850-383-1052
Mailing Address - Street 1:2808 N. REMINGTON GREEN CIRCLE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-383-1052
Mailing Address - Fax:850-383-1366
Practice Address - Street 1:2808 N. REMINGTON GREEN CIRCLE
Practice Address - Street 2:SUITE 100
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-383-1052
Practice Address - Fax:850-383-1366
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TCG DENTAL SPECIALIST, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-29
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 00108511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty