Organization
CHARLOTTE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN J MOURSELAS DDS (MANAGING MEMBER)
(941) 624-4000
Entity
Organization
Contact information
Practice address
18000 TOLEDO BLADE BLVD, PORT CHARLOTTE, FL 33948-1980
(941) 624-4000
(941) 624-2208
Mailing address
18000 TOLEDO BLADE BLVD, PORT CHARLOTTE, FL 33948-1980
(941) 624-4000
(941) 624-2208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16793
FL
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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