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General NPI Number Information
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NPI Number | 1467795435
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Entity Type | Organization
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Legal Business Name | BAYVIEW DENTAL HEALTH PROFESSIONALS
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 7442 N TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34243-1800
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Country | US
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Telephone | 941-536-6262
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Fax | 941-359-8123
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Provider Business Mailing Address
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Address Line | 7442 N TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34243-1800
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Country | US
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Telephone | 941-536-6262
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Fax | 941-359-8123
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. TIMMIE BARAN
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Credential |
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Telephone | 941-536-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN0010939
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License Number State | FL
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