Provider Demographics
NPI:1083822035
Name:GOLDEN BEIL & HORWITZ DENTISTRY PARTNERSHIP
Entity Type:Organization
Organization Name:GOLDEN BEIL & HORWITZ DENTISTRY PARTNERSHIP
Other - Org Name:DBA PRESTIGE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-789-1980
Mailing Address - Street 1:1641 DAVENPORT DRIVE
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655
Mailing Address - Country:US
Mailing Address - Phone:727-789-1980
Mailing Address - Fax:727-789-4686
Practice Address - Street 1:1641 DAVENPORT DRIVE
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655
Practice Address - Country:US
Practice Address - Phone:727-789-1980
Practice Address - Fax:727-789-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN110161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty