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Organization
DOUGLAS DENTISTRY P A
Active
Organization
DOUGLAS DENTISTRY P A
Active
Parent organization
DOUGLAS DENTISTRY P A
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOUGLAS DENTISTRY P A
Authorized official
SHAWN DOUGLAS DDS (PRESIDENT)
(727) 372-3200
Entity
Organization
Contact information
Practice address
1821 WELLNESS LN BLDG 3, TRINITY, FL 34655-5359
(727) 372-3200
Mailing address
1821 WELLNESS LN BLDG 3, TRINITY, FL 34655-5359
(727) 372-3200
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
04/03/2019
Last updated
09/04/2019
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