The Green Dental Studio Pa

LBN: The Green Dental Studio Pa
The Green Dental Studio Pa is an health care organization with primary practice located at 1330 Se 4Th Ave Ste L , Fort Lauderdale FL 33316-1958. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. The Green Dental Studio Pa can be contacted via phone (954) 990-8389, or through Alfonso, Jose Antonio via phone (786) 614-8927.

Contact Information

Primary practice address
1330 Se 4Th Ave Ste L Fort Lauderdale FL 33316-1958
Phone: (954) 990-8389
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Alfonso, Jose Antonio Doctor of Dental Medicine (DMD)
Phone: (786) 614-8927

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1134825052
LBN Legal business name The Green Dental Studio Pa
DBA Doing business as
Authorized official Alfonso, Jose Antonio Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2023
Last updated Feb 2nd, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134825052 NPPES
New Jersey MEDICAID 1760008486

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