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4800 Lakewood Ranch Blvd Bradenton FL 34211-4953 | |
| (941) 405-1507 | |
| (941) 405-1675 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4800 Lakewood Ranch Blvd, Bradenton, Florida |
| Authorized Official Name and Position | Steven Gregory Inman (VP FISCAL AFFAIRS/CFO) |
| Authorized Official Contact | 8148688258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4800 Lakewood Ranch Blvd Bradenton FL 34211-4953 Ph: (941) 405-1507 | 4800 Lakewood Ranch Blvd Bradenton FL 34211-4953 Ph: (941) 405-1507 |
| NPI Number | 1912258872 |
|---|---|
| Provider Enumeration Date | 10/01/2012 |
| Last Update Date | 05/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912258872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Dental Contracted Services Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6501 Drewrys Blf, Bradenton, FL 34203 Phone: 941-228-7788 | |
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