Healthcare Provider Details

I. General information

NPI: 1639618044
Provider Name (Legal Business Name): CALM CARE DENTAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12531 SOUTH DIXIE HIGHWAY
PINECREST FL
33156
US

IV. Provider business mailing address

12531 SOUTH DIXIE HIGHWAY
PINECREST FL
33156
US

V. Phone/Fax

Practice location:
  • Phone: 786-842-3132
  • Fax: 786-870-4283
Mailing address:
  • Phone: 786-842-3132
  • Fax: 786-870-4283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN14973
License Number StateFL

VIII. Authorized Official

Name: DR. MICHAEL W. BAILEY
Title or Position: OWNER
Credential:
Phone: 786-842-3132