Provider Demographics
NPI:1225627888
Name:DENTS, DEBEN
Entity Type:Individual
Prefix:
First Name:DEBEN
Middle Name:
Last Name:DENTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10213 PALERMO CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-5083
Mailing Address - Country:US
Mailing Address - Phone:786-319-6476
Mailing Address - Fax:
Practice Address - Street 1:10213 PALERMO CIR APT 202
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-5083
Practice Address - Country:US
Practice Address - Phone:786-319-6476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician