Organization
BRADNEY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN WALCOTT D.D.S (MANAGER)
(407) 378-4000
Entity
Organization
Contact information
Practice address
213 S DILLARD ST, SUITE 310, WINTER GARDEN, FL 34787-3596
(407) 378-4000
(727) 820-1199
Mailing address
213 S DILLARD ST, SUITE 310, WINTER GARDEN, FL 34787-3596
(407) 378-4000
(727) 820-1199
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DN16473
FL
Other
Enumeration date
11/13/2009
Last updated
11/13/2009
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