Individual
DR. BRENT JOHN WALDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13145 KINGS LAKE DR, GIBSONTON, FL 33534-3962
(843) 789-9738
Mailing address
15231 MERLINGLEN PL, LITHIA, FL 33547-3900
(843) 789-9738
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401410971
VA
122300000X
Dentist
Primary
DN28891
FL
Other
Enumeration date
11/18/2005
Last updated
03/05/2025
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