Provider Demographics
NPI:1881830941
Name:PINES DENTAL ASSOCIATES INC
Entity Type:Organization
Organization Name:PINES DENTAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:JAIME
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-432-6133
Mailing Address - Street 1:1541 N PALM AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3229
Mailing Address - Country:US
Mailing Address - Phone:954-432-6133
Mailing Address - Fax:954-432-8989
Practice Address - Street 1:1541 N PALM AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3229
Practice Address - Country:US
Practice Address - Phone:954-432-6133
Practice Address - Fax:954-432-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-19
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty