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General NPI Number Information
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NPI Number | 1306525274
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Entity Type | Organization
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Legal Business Name | SARASOTA BAY DENTAL
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 2809 UNIVERSITY PKWY
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City | SARASOTA
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State | FL
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Zip | 34243-4201
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Country | US
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Telephone | 941-200-3723
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 UNIVERSITY PKWY
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City | SARASOTA
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State | FL
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Zip | 34243-4201
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Country | US
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Telephone | 941-200-3723
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT MILLER
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Credential | DMD
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Telephone | 941-200-3723
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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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