Individual
BRIAN MICHAEL BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
825 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33603-3337
(813) 237-1982
(813) 232-0744
Mailing address
825 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33603-3337
(813) 237-1982
(813) 232-0744
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN16668
FL
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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