| Ellenton Family Dental Corp | |
|
5975 Factory Shops Blvd Ellenton FL 34222-4125 | |
| (941) 479-7936 | |
| (941) 479-7991 |
| Full Name | Ellenton Family Dental Corp |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5975 Factory Shops Blvd, Ellenton, Florida |
| Authorized Official Name and Position | Carla M Mathews (OFFICE MANAGER) |
| Authorized Official Contact | 9414797936 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellenton Family Dental Corp 5975 Factory Shops Blvd Ellenton FL 34222-4125 Ph: (941) 479-7936 | Ellenton Family Dental Corp 5975 Factory Shops Blvd Ellenton FL 34222-4125 Ph: (941) 479-7936 |
| NPI Number | 1184092629 |
|---|---|
| Provider Enumeration Date | 09/14/2015 |
| Last Update Date | 09/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184092629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Institute Of Computerized Dentistry, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3030 Us Highway 301 N, Ellenton, FL 34222 Phone: 941-722-0502 Fax: 941-722-3634 | |
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