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Organization
PP SD DENTISTRY LLC
Active
Organization
PP SD DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHENNATDA POLPORNVITOON DMD (OWNER)
(954) 383-8362
Entity
Organization
Contact information
Practice address
4333 S TAMIAMI TRL STE D, SARASOTA, FL 34231-3461
(941) 415-9779
(941) 415-9780
Mailing address
6951 SCRUB JAY DR, SARASOTA, FL 34241-5223
(954) 383-8362
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/01/2026
Last updated
08/01/2026
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