Provider Demographics
NPI:1639294689
Name:DENT ALL OF PALM CITY
Entity Type:Organization
Organization Name:DENT ALL OF PALM CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PEARLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-220-4100
Mailing Address - Street 1:3662 SW 30TH AVE
Mailing Address - Street 2:STE #3
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990
Mailing Address - Country:US
Mailing Address - Phone:772-220-4100
Mailing Address - Fax:772-220-4005
Practice Address - Street 1:3662 SW 30TH AVE
Practice Address - Street 2:STE #3
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990
Practice Address - Country:US
Practice Address - Phone:772-220-4100
Practice Address - Fax:772-220-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1223G0001X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty