Provider Demographics
NPI:1932201142
Name:OASIS DENTAL ASSOCIATES PA
Entity type:Organization
Organization Name:OASIS DENTAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-499-1599
Mailing Address - Street 1:10796 PINES BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PENBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026
Mailing Address - Country:US
Mailing Address - Phone:954-499-1599
Mailing Address - Fax:954-499-5799
Practice Address - Street 1:10796 PINES BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:PENBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026
Practice Address - Country:US
Practice Address - Phone:954-499-1599
Practice Address - Fax:954-499-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty