Organization
MANATEE ORAL AND FACIAL SURGERY CENTER LLC
Active
Organization
MANATEE ORAL AND FACIAL SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASHANT PANDYA DMD (OWNER)
(502) 644-7833
Entity
Organization
Contact information
Practice address
5460 LENA RD, UNIT 102, BRADENTON, FL 34211-9500
(502) 644-7833
(941) 492-7184
Mailing address
5460 LENA RD, UNIT 102, BRADENTON, FL 34211-9500
(502) 644-7833
(941) 492-7184
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN17268
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN17268
MEDICAL LICENSE
FL
Enumeration date
03/07/2009
Last updated
03/09/2009
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