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General NPI Number Information
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NPI Number | 1124646120
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Entity Type | Individual
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Provider Name | BRANDON J BOHRER DMD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 1745 S HIGHLAND AVE STE 6W
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City | CLEARWATER
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State | FL
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Zip | 33756-1852
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Country | US
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Telephone | 727-586-1402
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Fax |
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Provider Business Mailing Address
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Address Line | 215 ORANGE ST
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City | PALM HARBOR
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State | FL
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Zip | 34683-5224
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Country | US
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Telephone | 585-507-2684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 25137
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License Number State | FL
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