Provider Demographics
NPI:1639716921
Name:PLANES DENTAL GROUP, LLC
Entity Type:Organization
Organization Name:PLANES DENTAL GROUP, LLC
Other - Org Name:PLANES DENTAL MANAGEMENT, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:T
Authorized Official - Last Name:PETRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-800-6535
Mailing Address - Street 1:1500 SW MAPP RD
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2446
Mailing Address - Country:US
Mailing Address - Phone:772-800-6535
Mailing Address - Fax:772-210-3571
Practice Address - Street 1:1500 SW MAPP RD
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2446
Practice Address - Country:US
Practice Address - Phone:772-231-6004
Practice Address - Fax:772-231-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty