| Gator Dental Associates, Pa | |
|
6605 Se 221st St Hawthorne FL 32640-3815 | |
| (352) 481-2741 | |
| (352) 481-5341 |
| Full Name | Gator Dental Associates, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6605 Se 221st St, Hawthorne, Florida |
| Authorized Official Name and Position | Jay H Garlitz (PRESIDENT) |
| Authorized Official Contact | 3524812741 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gator Dental Associates, Pa Po Box 10 Hawthorne FL 32640-0010 Ph: (352) 481-2741 | Gator Dental Associates, Pa 6605 Se 221st St Hawthorne FL 32640-3815 Ph: (352) 481-2741 |
| NPI Number | 1689711905 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689711905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN 9207 (Florida) | Primary |
Gina Nicoloso Dmd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6605 Se 221st St, Hawthorne, FL 32640 Phone: 352-481-2741 Fax: 352-481-5341 |