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Individual

KONRAD MARINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1900 BROTHER GEENEN WAY, SARASOTA, FL 34236-7102
(941) 556-3233
(941) 955-8214
Mailing address
5771 GIRONA PL, SARASOTA, FL 34238-4721

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18929
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DN18929
DENTAL LICENSE
IL
Enumeration date
05/03/2016
Last updated
05/03/2016
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