Organization
ANNY B. VERA D.D.S., M.SC., P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNY B VERA D.D.S. (OWNER)
(386) 274-2021
Entity
Organization
Contact information
Practice address
1667 N CLYDE MORRIS BLVD # 1, DAYTONA BEACH, FL 32117-5500
(386) 274-2021
(386) 274-1743
Mailing address
1667 N CLYDE MORRIS BLVD # 1, DAYTONA BEACH, FL 32117-5500
(386) 274-2021
(386) 274-1743
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15075
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6482270001
PTAN NUMBER
FL
Enumeration date
02/09/2011
Last updated
11/07/2011
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