Healthcare Provider Details

I. General information

NPI: 1598652026
Provider Name (Legal Business Name): OSPREY DENTAL L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3976 DESTINATION DR #203
OSPREY FL
34229
US

IV. Provider business mailing address

3976 DESTINATION DR #203
OSPREY FL
34229
US

V. Phone/Fax

Practice location:
  • Phone: 941-375-8505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY KESLING
Title or Position: OWNER/DENTIST
Credential: D.D.S.
Phone: 941-735-3988