Individual
DR. JASON PAUL BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1614 HUNTINGTON PL, SAFETY HARBOR, FL 34695-5233
(727) 542-5754
Mailing address
1614 HUNTINGTON PL, SAFETY HARBOR, FL 34695-5233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19312
FL
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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