Provider Demographics
NPI:1396227278
Name:HAKUNA MATATA PEDIATRIC DENTISTRY OF NAPLES,PA
Entity type:Organization
Organization Name:HAKUNA MATATA PEDIATRIC DENTISTRY OF NAPLES,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,MS
Authorized Official - Phone:754-214-4808
Mailing Address - Street 1:2926 S UNIVERSITY DR APT 6204
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1407
Mailing Address - Country:US
Mailing Address - Phone:754-214-4808
Mailing Address - Fax:
Practice Address - Street 1:2544 NORTHBROOKE PLAZA DR STE 4
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-7960
Practice Address - Country:US
Practice Address - Phone:754-214-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN194441223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty