Provider Demographics
NPI:1326738469
Name:BELLAGIO DENTAL PLLC
Entity Type:Organization
Organization Name:BELLAGIO DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-705-0045
Mailing Address - Street 1:517 NORTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5408
Mailing Address - Country:US
Mailing Address - Phone:561-705-0045
Mailing Address - Fax:
Practice Address - Street 1:517 NORTHLAKE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5408
Practice Address - Country:US
Practice Address - Phone:561-705-0045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty