| Champagne Dental Corp | |
|
1330 S Belcher Rd Clearwater FL 33764-3713 | |
| (727) 535-3233 | |
| (727) 535-1185 |
| Full Name | Champagne Dental Corp |
|---|---|
| Speciality | Dentist |
| Location | 1330 S Belcher Rd, Clearwater, Florida |
| Authorized Official Name and Position | Holly Kay (VICE PRESIDENT) |
| Authorized Official Contact | 7272511907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Champagne Dental Corp 2385 Nw Executive Center Dr Ste 100 Boca Raton FL 33431-8510 Ph: (727) 251-1907 | Champagne Dental Corp 1330 S Belcher Rd Clearwater FL 33764-3713 Ph: (727) 535-3233 |
| NPI Number | 1265918312 |
|---|---|
| Provider Enumeration Date | 07/12/2018 |
| Last Update Date | 07/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265918312 | NPI | - | NPPES |
| 1649568767 | Other | FL | CATHERINE DE LA TORRE DMD |
| 1063545242 | Other | FL | GEORGE HITZEL DDS |
| 1164710976 | Other | FL | LINDSEY REZNIK DMD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN11998 (Florida) | Primary |
| 122300000X | Dentist | DN19345 (Florida) | Secondary |
| 122300000X | Dentist | DN19494 (Florida) | Secondary |
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