Individual
DR. PHIL POTEMPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1100 LOVELAND BLVD, PORT CHARLOTTE, FL 33980
(941) 624-7200
(941) 624-7274
Mailing address
1100 LOVELAND BLVD, PORT CHARLOTTE, FL 33980
(941) 624-7200
(941) 624-7274
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN17474
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02792420411
—
FL
05
—
076162100
—
FL
01
—
P351679422910
DR LICENSE
FL
Enumeration date
09/01/2006
Last updated
12/16/2016
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