Custom Crowns

LBN: Custom Crowns
Custom Crowns is an health care organization with primary practice located at 5400 S University Dr , Davie FL 33328-5312. The organization recently has 11 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Technologists, Technicians & Other Technical Service Providers / Medical Laboratory, Technologists, Technicians & Other Technical Service Providers / Clinical Laboratory Director, Non-physician, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Health Service, Ambulatory Health Care Facilities / Infusion Therapy, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Occupational Medicine, Laboratories / Clinical Medical Laboratory. Technologists, Technicians & Other Technical Service Providers / Medical Laboratory is the primary health care specialty. Custom Crowns can be contacted via phone (954) 947-0641, or through Martin, Tyshawn via phone (305) 788-7779.

Contact Information

Primary practice address
5400 S University Dr Davie FL 33328-5312
Phone: (954) 947-0641
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Martin, Tyshawn
Phone: (305) 788-7779

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X
Technologists, Technicians & Other Technical Service Providers / Medical Laboratory 246RM2200X
Technologists, Technicians & Other Technical Service Providers / Clinical Laboratory Director, Non-physician 247ZC0005X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Ambulatory Health Care Facilities / Community Health 261QC1500X
Ambulatory Health Care Facilities / Health Service 261QH0100X
Ambulatory Health Care Facilities / Infusion Therapy 261QI0500X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Occupational Medicine 261QX0100X
Laboratories / Clinical Medical Laboratory 291U00000X

Profile Details

NPI number 1538813910
LBN Legal business name Custom Crowns
DBA Doing business as
Authorized official Martin, Tyshawn
Entity Organization
Organization subpart 1 No
Enumeration date Feb 4th, 2022
Last updated Feb 4th, 2022 - about 2 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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