Individual
DANE GEORGE FORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3466 CLARK ROAD, SUITE- 410, SARASOTA, FL 34231
(941) 927-1705
Mailing address
2502 N ROCKY POINT DR, SUITE- 1000, TAMPA, FL 33607-1421
(813) 288-1999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN4922
FL
Other
Enumeration date
09/26/2007
Last updated
09/26/2007
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