Provider Demographics
NPI:1972752830
Name:ONSITE DENTAL RESPONSE LLC.
Entity type:Organization
Organization Name:ONSITE DENTAL RESPONSE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DEMERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-802-4446
Mailing Address - Street 1:1205 N.DIXIE HWY.
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-2122
Mailing Address - Country:US
Mailing Address - Phone:561-802-4446
Mailing Address - Fax:561-802-9997
Practice Address - Street 1:1205 N.DIXIE HWY.
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-2122
Practice Address - Country:US
Practice Address - Phone:561-802-4446
Practice Address - Fax:561-802-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty