Cross County Mall Dental, Pa

LBN: Cross County Mall Dental, Pa
Cross County Mall Dental, Pa is an health care organization with primary practice located at 4288 Okeechobee Blvd , West Palm Beach FL 33409-3206. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Cross County Mall Dental, Pa can be contacted via phone (561) 683-6247, or through Krasnov, Rostislav via phone (561) 683-6247.

Contact Information

Primary practice address
4288 Okeechobee Blvd West Palm Beach FL 33409-3206
Phone: (561) 683-6247
Fax: (561) 683-6248
Website:
Map and Directions
Authorized official contact:
Name: Krasnov, Rostislav Doctor of Dental Surgery (DDS)
Phone: (561) 683-6247

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X

Profile Details

NPI number 1972815991
LBN Legal business name Cross County Mall Dental, Pa
DBA Doing business as
Authorized official Krasnov, Rostislav Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2010
Last updated Dec 3rd, 2018 - about 6 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 1972815991 NPPES
Florida MEDICAID 076461200

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