Provider Demographics
NPI:1144781543
Name:FOREST HILLS DENTAL
Entity Type:Organization
Organization Name:FOREST HILLS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:MORGANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-935-6666
Mailing Address - Street 1:1335 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7755
Mailing Address - Country:US
Mailing Address - Phone:813-935-6666
Mailing Address - Fax:813-935-9416
Practice Address - Street 1:1335 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7755
Practice Address - Country:US
Practice Address - Phone:813-935-6666
Practice Address - Fax:813-935-9416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty