Daxon & Grundset Dentistry | |
111 2nd Ave Ne Ste 1104 St Petersburg FL 33701-3443 | |
(727) 282-1970 | |
(727) 608-1980 |
Full Name | Daxon & Grundset Dentistry |
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Speciality | Clinic/center - Dental |
Location | 111 2nd Ave Ne Ste 1104, St Petersburg, Florida |
Authorized Official Name and Position | Kenneth Grundest (PARTNER) |
Authorized Official Contact | 7272821970 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Daxon & Grundset Dentistry 111 2nd Ave Ne Ste 1104 St Petersburg FL 33701-3443 Ph: (727) 282-1970 | Daxon & Grundset Dentistry 111 2nd Ave Ne Ste 1104 St Petersburg FL 33701-3443 Ph: (727) 282-1970 |
NPI Number | 1639599962 |
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Provider Enumeration Date | 04/25/2014 |
Last Update Date | 04/25/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639599962 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | DN 04596 (Florida) | Primary |
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