| Lake View Family Dentistry Pa | |
|
13728 Office Park Court Bayonet Point FL 34667 | |
| (727) 863-9669 | |
| (727) 862-8907 |
| Full Name | Lake View Family Dentistry Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13728 Office Park Court, Bayonet Point, Florida |
| Authorized Official Name and Position | Stephen M Durett (PRESIDENT) |
| Authorized Official Contact | 7278639669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake View Family Dentistry Pa 13728 Office Park Court Bayonet Point FL 34667 Ph: (727) 863-9669 | Lake View Family Dentistry Pa 13728 Office Park Court Bayonet Point FL 34667 Ph: (727) 863-9669 |
| NPI Number | 1487750378 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487750378 | NPI | - | NPPES |
| 539393 | Other | FL | UNITED HEALTH CARE |
| 56988 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN14566 (Florida) | Primary |
| 1223G0001X | Dentist - General Practice | DN14685 (Florida) | Secondary |