Provider Demographics
NPI:1316353360
Name:DENTAL CHOICE MOBILE FLORIDA LLC
Entity type:Organization
Organization Name:DENTAL CHOICE MOBILE FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STERLING
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-260-2601
Mailing Address - Street 1:2592 EAGLES CIR
Mailing Address - Street 2:UNIT 2
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1588
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11077 SW 5TH CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-7025
Practice Address - Country:US
Practice Address - Phone:724-260-2601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty