Provider Demographics
NPI:1225716780
Name:NORTHCLIFFE DENTAL STUDIO LLC
Entity Type:Organization
Organization Name:NORTHCLIFFE DENTAL STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHIUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:IFAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-903-8587
Mailing Address - Street 1:10448 NORTHCLIFFE BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-3609
Mailing Address - Country:US
Mailing Address - Phone:954-903-8587
Mailing Address - Fax:
Practice Address - Street 1:10448 NORTHCLIFFE BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3609
Practice Address - Country:US
Practice Address - Phone:954-903-8587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty