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1906 59th St W Ste G Bradenton FL 34209-4639 | |
| (941) 792-3899 | |
| (941) 792-3779 |
| Full Name | |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1906 59th St W Ste G, Bradenton, Florida |
| Authorized Official Name and Position | Robert L Demint (CREDENTIALING) |
| Authorized Official Contact | 8136922205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1 N Dale Mabry Hwy Ste 605 Tampa FL 33609-2781 Ph: (813) 692-2205 | 1906 59th St W Ste G Bradenton FL 34209-4639 Ph: (941) 792-3899 |
| NPI Number | 1225754062 |
|---|---|
| Provider Enumeration Date | 10/13/2022 |
| Last Update Date | 08/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225754062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
| 1223P0700X | Dentist - Prosthodontics | (* (Not Available)) | Secondary |
Dental Contracted Services Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6501 Drewrys Blf, Bradenton, FL 34203 Phone: 941-228-7788 | |
David D. Fabre, Dds, Ms, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2111 59th St W, Bradenton, FL 34209 Phone: 941-792-4166 | |
Meadows Adult Dental Services Sr 64 Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9916 E State Road 64, Bradenton, FL 34212 Phone: 941-745-1143 Fax: 941-708-0555 | |