Provider Demographics
NPI:1184371643
Name:FLORENCE FAMILY DENTISTRY PLLC
Entity type:Organization
Organization Name:FLORENCE FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BING
Authorized Official - Middle Name:
Authorized Official - Last Name:DAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-655-6912
Mailing Address - Street 1:75 BRADFORD WALK
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-4532
Mailing Address - Country:US
Mailing Address - Phone:860-655-6912
Mailing Address - Fax:
Practice Address - Street 1:190 NONOTUCK ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1962
Practice Address - Country:US
Practice Address - Phone:413-923-9883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty