Provider Demographics
NPI:1598573271
Name:PRIME DENTAL CARE LLC
Entity type:Organization
Organization Name:PRIME DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-620-5858
Mailing Address - Street 1:516 LAKEVIEW RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3302
Mailing Address - Country:US
Mailing Address - Phone:727-620-5858
Mailing Address - Fax:727-620-5858
Practice Address - Street 1:516 LAKEVIEW RD STE 1
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3302
Practice Address - Country:US
Practice Address - Phone:727-620-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental