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General NPI Number Information
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NPI Number | 1306459441
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Entity Type | Organization
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Legal Business Name | CONTEMPORARY DENTAL PLLC
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 5136 OCEAN BLVD
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City | SIESTA KEY
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State | FL
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Zip | 34242-1637
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Country | US
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Telephone | 646-263-2980
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Fax |
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Provider Business Mailing Address
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Address Line | 5812 VALENTE PL
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City | SARASOTA
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State | FL
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Zip | 34238-1706
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Country | US
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Telephone | 941-302-7778
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Fax |
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Authorized Official
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Title or Position | CIO
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Name | MR. MICHAEL O LYONS
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Credential |
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Telephone | 646-263-2980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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