# MANATEE ORAL AND FACIAL SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811138662
- **Authorized official:** PRASHANT PANDYA DMD (OWNER)
- **Authorized official phone:** (502) 644-7833

## Contact information

- **Practice address:** 5460 LENA RD, UNIT 102, BRADENTON, FL 34211-9500
- **Practice address phone:** (502) 644-7833
- **Practice address fax:** (941) 492-7184
- **Mailing address:** 5460 LENA RD, UNIT 102, BRADENTON, FL 34211-9500
- **Mailing address phone:** (502) 644-7833
- **Mailing address fax:** (941) 492-7184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN17268 | FL | Yes |

## Other

- **Enumeration date:** 03/07/2009
- **Last updated:** 03/09/2009