Provider Demographics
NPI:1457861098
Name:SARRIA DENTAL INC.
Entity Type:Organization
Organization Name:SARRIA DENTAL INC.
Other - Org Name:INNOVATION DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULO
Authorized Official - Middle Name:
Authorized Official - Last Name:SARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-227-2718
Mailing Address - Street 1:6180 W SAMPLE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3274
Mailing Address - Country:US
Mailing Address - Phone:954-227-2718
Mailing Address - Fax:954-227-7421
Practice Address - Street 1:6180 W SAMPLE RD STE 109
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-3274
Practice Address - Country:US
Practice Address - Phone:954-227-2718
Practice Address - Fax:954-227-7421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARRIA DENTAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19057261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental