Provider Demographics
NPI:1689712127
Name:THE DENTIST PLACE
Entity Type:Organization
Organization Name:THE DENTIST PLACE
Other - Org Name:THE DENTIST PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MURAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-799-0650
Mailing Address - Street 1:27001 U.S. HIGHWAY 19 N
Mailing Address - Street 2:SUITE 8520
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761
Mailing Address - Country:US
Mailing Address - Phone:727-799-0650
Mailing Address - Fax:727-797-9273
Practice Address - Street 1:27001 U.S. HIGHWAY 19 N
Practice Address - Street 2:SUITE 8520
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761
Practice Address - Country:US
Practice Address - Phone:727-799-0650
Practice Address - Fax:727-797-9273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 0008198122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty