Organization
SUPREME SMILES OF SARASOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELVIN MATHEW KORATTIYIL DMD (DENTIST)
(941) 923-7060
Entity
Organization
Contact information
Practice address
2345 BEE RIDGE RD, SUITE 4, SARASOTA, FL 34239-6251
(941) 923-7060
(941) 925-4724
Mailing address
2345 BEE RIDGE RD, SUITE 4, SARASOTA, FL 34239-6251
(941) 923-7060
(941) 925-4724
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN18851
FL
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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