Provider Demographics
NPI:1922077650
Name:DENTAQUEST OF FLORIDA, INC.
Entity Type:Organization
Organization Name:DENTAQUEST OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-417-7140
Mailing Address - Street 1:2100 PONCE DE LEON BLVD.
Mailing Address - Street 2:SUITE 950
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:800-417-7140
Mailing Address - Fax:
Practice Address - Street 1:2100 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 950
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5215
Practice Address - Country:US
Practice Address - Phone:305-443-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL67016302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization