| Divergent Dental Group, Llc | |
|
1861 Placida Rd Ste 105 Englewood FL 34223-4900 | |
| (941) 460-3565 | |
| Not Available |
| Full Name | Divergent Dental Group, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1861 Placida Rd Ste 105, Englewood, Florida |
| Authorized Official Name and Position | George Strickland (OWNER) |
| Authorized Official Contact | 9412131007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divergent Dental Group, Llc 1861 Placida Rd Ste 105 Englewood FL 34223-4900 Ph: () - | Divergent Dental Group, Llc 1861 Placida Rd Ste 105 Englewood FL 34223-4900 Ph: (941) 460-3565 |
| NPI Number | 1497379259 |
|---|---|
| Provider Enumeration Date | 06/07/2020 |
| Last Update Date | 06/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497379259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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