Provider Demographics
NPI:1932300688
Name:PANAHI, HARRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:
Last Name:PANAHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 ROYAL PALM BLVD
Mailing Address - Street 2:STE. 110
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5733
Mailing Address - Country:US
Mailing Address - Phone:954-255-5858
Mailing Address - Fax:954-255-9393
Practice Address - Street 1:8100 ROYAL PALM BLVD
Practice Address - Street 2:STE. 110
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5733
Practice Address - Country:US
Practice Address - Phone:954-255-5858
Practice Address - Fax:954-255-9393
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18481122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program