Provider Demographics
NPI:1760964050
Name:UMOREN DENTAL, P.A.
Entity Type:Organization
Organization Name:UMOREN DENTAL, P.A.
Other - Org Name:SMILES BY ANNE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE-MARIE
Authorized Official - Middle Name:USHUNU
Authorized Official - Last Name:UMOREN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-403-5901
Mailing Address - Street 1:15068 S JOG RD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1218
Mailing Address - Country:US
Mailing Address - Phone:561-403-5901
Mailing Address - Fax:561-403-5972
Practice Address - Street 1:15068 S JOG RD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1218
Practice Address - Country:US
Practice Address - Phone:561-403-5901
Practice Address - Fax:561-403-5972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN207501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty