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General NPI Number Information
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NPI Number | 1609033380
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Entity Type | Organization
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Legal Business Name | PARK DENTAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 7315 MERCHANT CT
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City | SARASOTA
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State | FL
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Zip | 34240-8463
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Country | US
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Telephone | 941-907-7792
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Fax | 941-907-0274
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Provider Business Mailing Address
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Address Line | 7315 MERCHANT CT
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City | SARASOTA
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State | FL
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Zip | 34240-8463
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Country | US
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Telephone | 941-907-7792
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Fax | 941-907-0274
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Authorized Official
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Title or Position | OWNER
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Name | DR. FRANCISCO J MARCANO-SOLTERO
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Credential | D.M.D
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Telephone | 941-907-7792
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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 | DN15046
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License Number State | FL
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