Provider Demographics
NPI: | 1518284710 |
---|---|
Name: | FAMILY DENTAL |
Entity Type: | Organization |
Organization Name: | FAMILY DENTAL |
Other - Org Name: | ELBA FRANCO DDSPA |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ELBA |
Authorized Official - Middle Name: | I |
Authorized Official - Last Name: | FRANCO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DDS |
Authorized Official - Phone: | 305-631-1998 |
Mailing Address - Street 1: | 2260 SW 8TH ST |
Mailing Address - Street 2: | SUITE 201 |
Mailing Address - City: | MIAMI |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33135-4924 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 305-631-1998 |
Mailing Address - Fax: | 305-631-1393 |
Practice Address - Street 1: | 2260 SW 8TH ST |
Practice Address - Street 2: | SUITE 201 |
Practice Address - City: | MIAMI |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33135-4924 |
Practice Address - Country: | US |
Practice Address - Phone: | 305-631-1998 |
Practice Address - Fax: | 305-631-1393 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-04-27 |
Last Update Date: | 2010-04-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | DN17580 | 122300000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty |