Organization
CLEARWHITE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BRADLEY JERGINS DMD (OWNER/OPERATOR)
(727) 791-8823
Entity
Organization
Contact information
Practice address
1831 N BELCHER RD, SUITE F-3, CLEARWATER, FL 33765-1449
(727) 791-8823
(727) 725-4534
Mailing address
1831 NORTH BELCHER ROAD, SUITE F-3, CLEARWATER, FL 33765-1453
(727) 791-8823
(727) 725-4534
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN15034
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN15034
STATE DENTAL LICENSE
FL
Enumeration date
04/23/2014
Last updated
03/07/2023
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