Provider Demographics
NPI:1376785956
Name:ROYAL DENTAL CARE PA
Entity Type:Organization
Organization Name:ROYAL DENTAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:SKAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-530-3967
Mailing Address - Street 1:7500 NW 5TH ST
Mailing Address - Street 2:SUITE#110
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1612
Mailing Address - Country:US
Mailing Address - Phone:954-530-3967
Mailing Address - Fax:954-530-3968
Practice Address - Street 1:7500 NW 5TH ST
Practice Address - Street 2:SUITE#110
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1612
Practice Address - Country:US
Practice Address - Phone:954-530-3967
Practice Address - Fax:954-530-3968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN168511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty