Provider Demographics
NPI:1063996726
Name:PLANES DENTAL MANAGEMENT, LLC
Entity type:Organization
Organization Name:PLANES DENTAL MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLANES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:772-231-6004
Mailing Address - Street 1:4755 HIGHWAY A1A
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-5402
Mailing Address - Country:US
Mailing Address - Phone:772-231-6004
Mailing Address - Fax:772-231-7249
Practice Address - Street 1:4755 HIGHWAY A1A
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-5402
Practice Address - Country:US
Practice Address - Phone:772-231-6004
Practice Address - Fax:772-231-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN20254OtherDENTAL LICENSE