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2787 Sycamore St Building F, Suite 106 North Port FL 34289-9513 | |
| (941) 223-7228 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2787 Sycamore St, North Port, Florida |
| Authorized Official Name and Position | Mark Chris Burne (CEO/OWNER) |
| Authorized Official Contact | 9412237228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 49975 Sarasota FL 34230-6975 Ph: (941) 223-7228 | 2787 Sycamore St Building F, Suite 106 North Port FL 34289-9513 Ph: (941) 223-7228 |
| NPI Number | 1295275964 |
|---|---|
| Provider Enumeration Date | 03/01/2017 |
| Last Update Date | 03/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295275964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN18166 (Florida) | Primary |
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