Provider Demographics
NPI:1619705456
Name:SMART ARCHES DENTAL IMPLANTS OF FLORIDA, PLLC
Entity type:Organization
Organization Name:SMART ARCHES DENTAL IMPLANTS OF FLORIDA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:R PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-981-7314
Mailing Address - Street 1:13770 BEACH BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7227
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13770 BEACH BLVD STE 6
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7227
Practice Address - Country:US
Practice Address - Phone:904-644-4491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental