Provider Demographics
NPI:1104018100
Name:PLANTATION DENTAL GROUP PA
Entity Type:Organization
Organization Name:PLANTATION DENTAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:NADEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-732-8665
Mailing Address - Street 1:1301 W BOYNTON BEACH BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3420
Mailing Address - Country:US
Mailing Address - Phone:561-732-8665
Mailing Address - Fax:561-732-8903
Practice Address - Street 1:1301 W BOYNTON BEACH BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3420
Practice Address - Country:US
Practice Address - Phone:561-732-8665
Practice Address - Fax:561-732-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty