Organization
GENESIS HEALTH CLINIC & SERVICES, INC.
Active
Other names
Genesis Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MCCLOUD (PRESIDENT/CEO)
(941) 363-1852
Entity
Organization
Contact information
Practice address
247 TAMIAMI TRL S, NOKOMIS, FL 34275-3136
(941) 486-8500
(941) 412-9400
Mailing address
3333 N WASHINGTON BLVD, SUITE 3, SARASOTA, FL 34234-6221
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 4922
FL
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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