Provider Demographics
NPI:1487883286
Name:CENTER FOR DENTAL IMPLANTS OF SOUTH FLORIDA
Entity type:Organization
Organization Name:CENTER FOR DENTAL IMPLANTS OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-935-4991
Mailing Address - Street 1:2999 NE 191ST ST
Mailing Address - Street 2:STE 210
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3123
Mailing Address - Country:US
Mailing Address - Phone:305-935-4991
Mailing Address - Fax:
Practice Address - Street 1:2999 NE 191ST ST
Practice Address - Street 2:STE 210
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3123
Practice Address - Country:US
Practice Address - Phone:305-935-4991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00110761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty