Provider Demographics
NPI:1134909021
Name:DENTAL DESIGNS OF PLANTATION INC
Entity type:Organization
Organization Name:DENTAL DESIGNS OF PLANTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN DIR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-473-6400
Mailing Address - Street 1:10019 CLEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1000
Mailing Address - Country:US
Mailing Address - Phone:954-473-6400
Mailing Address - Fax:
Practice Address - Street 1:10019 CLEARY BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1000
Practice Address - Country:US
Practice Address - Phone:954-473-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental