Provider Demographics
NPI:1689354888
Name:DENTAL CARE ASSOCIATION,CORP
Entity Type:Organization
Organization Name:DENTAL CARE ASSOCIATION,CORP
Other - Org Name:DENTAL CARE ASSOCIATION,CORP
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-233-6575
Mailing Address - Street 1:9275 SW 152ND ST STE 106
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1773
Mailing Address - Country:US
Mailing Address - Phone:305-233-6575
Mailing Address - Fax:
Practice Address - Street 1:9275 SW 152ND ST STE 106
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1773
Practice Address - Country:US
Practice Address - Phone:305-233-6575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental