Provider Demographics
NPI:1598479511
Name:WHISPERING PINES DENTAL, LLC
Entity Type:Organization
Organization Name:WHISPERING PINES DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-497-4343
Mailing Address - Street 1:109 NATURE WALK PKWY UNIT 105
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-5065
Mailing Address - Country:US
Mailing Address - Phone:904-497-4343
Mailing Address - Fax:904-484-7563
Practice Address - Street 1:109 NATURE WALK PKWY UNIT 105
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-5065
Practice Address - Country:US
Practice Address - Phone:904-497-4343
Practice Address - Fax:904-484-7563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty