| Dental Assoc Of South Brandon | |
|
611 E Bloomingdale Ave Suite C Brandon FL 33511-8127 | |
| (813) 684-6279 | |
| (813) 684-2189 |
| Full Name | Dental Assoc Of South Brandon |
|---|---|
| Speciality | Dentist |
| Location | 611 E Bloomingdale Ave, Brandon, Florida |
| Authorized Official Name and Position | Crystal B Barron (INSURANCE SUPERVISOR) |
| Authorized Official Contact | 8136846279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Assoc Of South Brandon 611 E Bloomingdale Ave Suite C Brandon FL 33511-8127 Ph: (813) 684-6279 | Dental Assoc Of South Brandon 611 E Bloomingdale Ave Suite C Brandon FL 33511-8127 Ph: (813) 684-6279 |
| NPI Number | 1588088223 |
|---|---|
| Provider Enumeration Date | 02/18/2014 |
| Last Update Date | 02/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588088223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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