Organization
DIETRICH DENTAL SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LOUIS DIETRICH DDS (PRESIDENT)
(941) 625-7877
Entity
Organization
Contact information
Practice address
17178 TOLEDO BLADE BLVD, PORT CHARLOTTE, FL 33954-2626
(941) 625-7877
(941) 625-4349
Mailing address
17178 TOLEDO BLADE BLVD, PORT CHARLOTTE, FL 33954-2626
(941) 625-7877
(941) 625-4349
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN9422
FL
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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