Provider Demographics
NPI:1104034503
Name:OAKLAND DENTAL, LLC
Entity Type:Organization
Organization Name:OAKLAND DENTAL, LLC
Other - Org Name:FAMILY DENTISTRY OF FLORIDA, LAUDERDALE LAKES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ARON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-486-0101
Mailing Address - Street 1:4416 W. OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313
Mailing Address - Country:US
Mailing Address - Phone:954-486-0101
Mailing Address - Fax:954-486-0588
Practice Address - Street 1:4416 W. OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313
Practice Address - Country:US
Practice Address - Phone:954-486-0101
Practice Address - Fax:954-486-0588
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OAKLAND DENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-18
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty