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NPI Code Detail

MEDICARE: BARTLETT FAMILY AND COSMETIC DENTISTRY, PLLC

MEDICARE: BARTLETT FAMILY AND COSMETIC DENTISTRY, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1437881950
Entity Type Code : Organization
Provider Name (Legal Business Name) : BARTLETT FAMILY AND COSMETIC DENTISTRY, PLLC
Provider Business Mailing Address
First Line : 208 HOSPITAL DR NE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-5068
Country : US
Telephone Number : 850-243-8124
Fax Number :
Provider Business Practice Location Address
First Line : 208 HOSPITAL DR NE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-5068
Country : US
Telephone Number : 850-243-8124
Fax Number :
Authorized Official
Title or Position : CREDENTIALING LEAD
Name : VICENTA REYES
Credential :
Telephone Number : 972-869-3789
Provider Enumeration Date : 06/24/2022
Last Update Date : 06/24/2022

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Directions to “BARTLETT FAMILY AND COSMETIC DENTISTRY, PLLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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