Provider Demographics
NPI:1326382177
Name:DMDDDS, INC.
Entity Type:Organization
Organization Name:DMDDDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRUGIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:850-492-7647
Mailing Address - Street 1:12385 SORRENTO RD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8664
Mailing Address - Country:US
Mailing Address - Phone:850-492-7647
Mailing Address - Fax:850-492-7583
Practice Address - Street 1:12385 SORRENTO RD
Practice Address - Street 2:SUITE B-1
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8664
Practice Address - Country:US
Practice Address - Phone:850-492-7647
Practice Address - Fax:850-492-7583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-18
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN96021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty