Organization
FAMILY DENTAL CARE OF SOUTH BRADENTON
Active
Parent organization
FAMILY DENTAL CARE OF SOUTH BRADENTON
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY DENTAL CARE OF SOUTH BRADENTON
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
3565 53RD AVE W, BRADENTON, FL 34210-3489
(941) 758-8900
Mailing address
3565 53RD AVE W, BRADENTON, FL 34210-3489
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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