MEDICARE: DIXIE ENDODONTIC SPECIALISTS INC.

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1871959262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIXIE ENDODONTIC SPECIALISTS INC.

Provider Business Mailing Address
First Line	:	6000 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-4028
Country	:	US
Telephone Number	:	561-582-7660
Fax Number	:	561-588-7316

Provider Business Practice Location Address
First Line	:	6000 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-4028
Country	:	US
Telephone Number	:	561-582-7660
Fax Number	:	561-588-7316

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRIAN CURTIS DEWEY
Credential	:	D.D.S.
Telephone Number	:	561-582-7660

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	01/14/2016

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