| Banyan Dental Group, L.l.c. | |
|
1820 58th Ave Suite 101 Vero Beach FL 32966-4673 | |
| (772) 567-2132 | |
| Not Available |
| Full Name | Banyan Dental Group, L.l.c. |
|---|---|
| Speciality | Dentist |
| Location | 1820 58th Ave, Vero Beach, Florida |
| Authorized Official Name and Position | Bruce Hoffman (PRESIDENT) |
| Authorized Official Contact | 7725672132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banyan Dental Group, L.l.c. 1820 58th Ave Suite 101 Vero Beach FL 32966-4673 Ph: (772) 567-2132 | Banyan Dental Group, L.l.c. 1820 58th Ave Suite 101 Vero Beach FL 32966-4673 Ph: (772) 567-2132 |
| NPI Number | 1477672475 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 03/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477672475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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