Individual
MS. BRENDA ANN MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRDH
Contact information
Practice address
4161 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-9204
(941) 255-8500
Mailing address
4239 BUR ST, PORT CHARLOTTE, FL 33948-9411
(941) 204-1679
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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