Bayou Dental, Pa | |
4461 Bayou Blvd Pensacola FL 32503-2601 | |
(850) 476-5233 | |
Not Available |
Full Name | Bayou Dental, Pa |
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Speciality | Dentist - General Practice |
Location | 4461 Bayou Blvd, Pensacola, Florida |
Authorized Official Name and Position | James D Callahan (PRESIDENT) |
Authorized Official Contact | 8504765233 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bayou Dental, Pa 4461 Bayou Blvd Pensacola FL 32503-2601 Ph: (850) 476-5233 | Bayou Dental, Pa 4461 Bayou Blvd Pensacola FL 32503-2601 Ph: (850) 476-5233 |
NPI Number | 1407898158 |
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Provider Enumeration Date | 06/10/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407898158 | NPI | - | NPPES |
1808923 | Other | FL | UNITED CONCORDIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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