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General NPI Number Information
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NPI Number | 1487968657
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Entity Type | Organization
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Legal Business Name | PREMIER DENTISTRY OF SARASOTA, PLC
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 2477 STICKNEY POINT RD. SUITE 100A
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City | SARASOTA
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State | FL
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Zip | 34231
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Country | US
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Telephone | 941-924-7571
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Fax | 941-922-6815
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Provider Business Mailing Address
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Address Line | 2477 STICKNEY POINT RD SUITE 100A
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City | SARASOTA
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State | FL
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Zip | 34231-4076
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Country | US
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Telephone | 941-924-7571
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Fax | 941-922-6815
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON J SWARTZ
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Credential | D.M.D.
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Telephone | 941-924-7571
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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 | DN15877
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License Number State | FL
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