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 |
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