Provider Demographics
NPI:1851747083
Name:GROVES DENTAL CARE P.A.
Entity Type:Organization
Organization Name:GROVES DENTAL CARE P.A.
Other - Org Name:GROVES DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKHECHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-716-0338
Mailing Address - Street 1:15673 SOUTHERN BLVD. #109
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE GROVES
Mailing Address - State:FL
Mailing Address - Zip Code:33470
Mailing Address - Country:US
Mailing Address - Phone:561-328-9050
Mailing Address - Fax:
Practice Address - Street 1:15673 SOUTHERN BLVD.
Practice Address - Street 2:109
Practice Address - City:LOXAHATCHEE GROVES
Practice Address - State:FL
Practice Address - Zip Code:33470
Practice Address - Country:US
Practice Address - Phone:561-328-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental