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Organization
PALM BAY DENTAL CENTER PA
Active
Organization
PALM BAY DENTAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBHASH GANPAT REGE DDS (PRESIDENT)
(321) 725-5512
Entity
Organization
Contact information
Practice address
1764 PALM BAY ROAD NE, PALM BAY, FL 32905-2904
(321) 725-5512
(321) 725-5592
Mailing address
1764 PALM BAY ROAD NE, PALM BAY, FL 32905-2904
(321) 725-5512
(321) 725-5592
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
FL011148
FL
Other
Enumeration date
11/30/2006
Last updated
03/06/2013
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