Individual
DR. DWAYNE BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2468 W BRANDON BLVD, BRANDON, FL 33511-4717
(813) 257-8318
Mailing address
2468 W BRANDON BLVD, BRANDON, FL 33511-4717
(813) 257-8318
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19547
FL
Other
Enumeration date
03/13/2007
Last updated
04/13/2022
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