Provider Demographics
NPI:1174927586
Name:PREMIER DENTISTRY, INC.
Entity type:Organization
Organization Name:PREMIER DENTISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:CASEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-686-2077
Mailing Address - Street 1:1501 PRESIDENTIAL WAY
Mailing Address - Street 2:SUITE 15
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1800
Mailing Address - Country:US
Mailing Address - Phone:561-686-2077
Mailing Address - Fax:561-686-2257
Practice Address - Street 1:1501 PRESIDENTIAL WAY
Practice Address - Street 2:SUITE 15
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1800
Practice Address - Country:US
Practice Address - Phone:561-686-2077
Practice Address - Fax:561-686-2257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty