Healthcare Provider Details

I. General information

NPI: 1861666802
Provider Name (Legal Business Name): LINDA BEYER LAABS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3826 COUNTRYSIDE LANE
SARASOTA FL
34233
US

IV. Provider business mailing address

3826 COUNTRYSIDE LANE
SARASOTA FL
34233
US

V. Phone/Fax

Practice location:
  • Phone: 941-923-4808
  • Fax: 941-923-4808
Mailing address:
  • Phone: 941-923-4808
  • Fax: 941-923-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN9258
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: