Healthcare Provider Details

I. General information

NPI: 1073421285
Provider Name (Legal Business Name): BRYAN CARLTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5231 UNIVERSITY PKWY UNIT 120
UNIVERSITY PARK FL
34201-3009
US

IV. Provider business mailing address

5231 UNIVERSITY PKWY UNIT 120
UNIVERSITY PARK FL
34201-3009
US

V. Phone/Fax

Practice location:
  • Phone: 941-363-0458
  • Fax:
Mailing address:
  • Phone: 941-363-0458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32166
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: