Eric R. Claussen, D.m.d., P.a. | |
2624 Jenks Ave Panama City FL 32405-4311 | |
(850) 215-0798 | |
Not Available |
Full Name | Eric R. Claussen, D.m.d., P.a. |
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Speciality | Dentist |
Location | 2624 Jenks Ave, Panama City, Florida |
Authorized Official Name and Position | Eric Richard Claussen (PRESIDENT) |
Authorized Official Contact | 4074084880 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Eric R. Claussen, D.m.d., P.a. 2624 Jenks Ave Panama City FL 32405-4311 Ph: (850) 215-0798 | Eric R. Claussen, D.m.d., P.a. 2624 Jenks Ave Panama City FL 32405-4311 Ph: (850) 215-0798 |
NPI Number | 1790087138 |
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Provider Enumeration Date | 11/17/2010 |
Last Update Date | 06/29/2012 |
Medicare PECOS PAC ID | 9830373323 |
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Medicare Enrollment ID | O20110407000194 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790087138 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | D17080 (Florida) | Primary |
Provider Name | Eric Richard Claussen |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1194983965 PECOS PAC ID: 2466636956 Enrollment ID: I20110407000218 |
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