Provider Demographics
NPI:1205394343
Name:DENTIST DAY OFF
Entity Type:Organization
Organization Name:DENTIST DAY OFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:267-241-5473
Mailing Address - Street 1:9121 N MILITARY TRL STE 209
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5988
Mailing Address - Country:US
Mailing Address - Phone:561-694-8380
Mailing Address - Fax:561-472-8807
Practice Address - Street 1:9121 N MILITARY TRL STE 209
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5988
Practice Address - Country:US
Practice Address - Phone:561-694-8380
Practice Address - Fax:561-472-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty