Provider Demographics
NPI:1073909420
Name:GARINE PROSTHODONTICS PA
Entity Type:Organization
Organization Name:GARINE PROSTHODONTICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:NABIL
Authorized Official - Last Name:GARINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-747-4272
Mailing Address - Street 1:345 JUPITER LAKES BLVD
Mailing Address - Street 2:STE 304
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7100
Mailing Address - Country:US
Mailing Address - Phone:561-747-4272
Mailing Address - Fax:561-747-4294
Practice Address - Street 1:345 JUPITER LAKES BLVD
Practice Address - Street 2:STE 304
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7100
Practice Address - Country:US
Practice Address - Phone:561-747-4272
Practice Address - Fax:561-747-4294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty