Organization
BUCKEYE DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN ERIC MATHENY DDS (PRESIDENT)
(941) 366-3636
Entity
Organization
Contact information
Practice address
3220 S TAMIAMI TRL, SARASOTA, FL 34239-5102
(941) 366-3636
(941) 957-0624
Mailing address
3220 S TAMIAMI TRL, SARASOTA, FL 34239-5102
(941) 366-3636
(941) 957-0624
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN24599
DENTAL LICENSE
FL
Enumeration date
05/18/2021
Last updated
05/18/2021
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