Provider Demographics
NPI:1164699252
Name:ADVANCED DENTAL INNOVATIONS
Entity Type:Organization
Organization Name:ADVANCED DENTAL INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:E
Authorized Official - Last Name:FONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-296-6600
Mailing Address - Street 1:514 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3523
Mailing Address - Country:US
Mailing Address - Phone:561-296-6600
Mailing Address - Fax:561-296-6601
Practice Address - Street 1:514 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3523
Practice Address - Country:US
Practice Address - Phone:561-296-6600
Practice Address - Fax:561-296-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty