Individual
EDWARD FLOYD BAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
140 6TH AVE, INDIALANTIC, FL 32903-3204
(321) 951-1577
Mailing address
140 6TH AVE, INDIALANTIC, FL 32903-3204
(321) 951-1577
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5975
FL
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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