Provider Demographics
NPI:1437367299
Name:TOTAL CARE DENTAL, PA
Entity Type:Organization
Organization Name:TOTAL CARE DENTAL, PA
Other - Org Name:FAMILY DENTISTRY OF FLORIDA, SUNRISE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-741-0346
Mailing Address - Street 1:4300 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6249
Mailing Address - Country:US
Mailing Address - Phone:954-741-0346
Mailing Address - Fax:954-741-9833
Practice Address - Street 1:4300 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6249
Practice Address - Country:US
Practice Address - Phone:954-741-0346
Practice Address - Fax:954-741-9833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty