Provider Demographics
NPI:1053048371
Name:PROMISING DENTAL CARE PARKLAND CORP
Entity type:Organization
Organization Name:PROMISING DENTAL CARE PARKLAND CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNE/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-294-4796
Mailing Address - Street 1:5973 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4542
Mailing Address - Country:US
Mailing Address - Phone:754-529-8214
Mailing Address - Fax:
Practice Address - Street 1:5973 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-4542
Practice Address - Country:US
Practice Address - Phone:754-529-8214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental