Provider Demographics
NPI:1952874364
Name:TOWN SQUARE DENTISTRY INC
Entity Type:Organization
Organization Name:TOWN SQUARE DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVED
Authorized Official - Middle Name:
Authorized Official - Last Name:FATMI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:786-457-3690
Mailing Address - Street 1:1250 S FEDERAL HWY # 101
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6041
Mailing Address - Country:US
Mailing Address - Phone:786-457-3690
Mailing Address - Fax:
Practice Address - Street 1:1250 S FEDERAL HWY # 101
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6041
Practice Address - Country:US
Practice Address - Phone:786-457-3690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental