Organization
JAY R. FROUG, D.M.D., P.A. D/B/A PINEBROOK DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY RICHARD FROUG DMD (OWNER)
(941) 795-0877
Entity
Organization
Contact information
Practice address
4868 CORTEZ RD W, BRADENTON, FL 34210-2803
(941) 795-0877
(941) 795-5316
Mailing address
4868 CORTEZ RD W, BRADENTON, FL 34210-2803
(941) 795-0877
(941) 795-5316
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0010494
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410947
UNITED CONCORDIA
PA
01
—
59129772
BCBS OF AL
AL
01
—
67366
BCBS
—
01
—
ZP9540
BCBS OF MA
MA
Enumeration date
05/23/2007
Last updated
06/25/2008
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