Provider Demographics
NPI:1467819052
Name:KIDS DENTAL NOW
Entity Type:Organization
Organization Name:KIDS DENTAL NOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANAMARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-951-3001
Mailing Address - Street 1:2500 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:M
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4834
Mailing Address - Country:US
Mailing Address - Phone:954-951-3001
Mailing Address - Fax:954-228-2199
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD
Practice Address - Street 2:M
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4834
Practice Address - Country:US
Practice Address - Phone:954-951-3001
Practice Address - Fax:954-228-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1366869331Medicaid