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General NPI Number Information
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NPI Number | 1629951926
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Entity Type | Organization
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Legal Business Name | COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
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Dates
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Enumeration Date | 07/26/2025
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Last Update Date | 07/26/2025
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Provider Practice Location Address
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Address Line | 9163 BABCOCK ST SE
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City | BREVARD
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State | FL
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Zip | 32909-1453
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Country | US
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Telephone | 321-490-1735
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Fax | 321-490-1738
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Provider Business Mailing Address
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Address Line | 9163 BABCOCK ST SE
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City | BREVARD
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State | FL
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Zip | 32909-1453
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Country | US
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Telephone | 321-490-1735
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Fax | 321-490-1738
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Authorized Official
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Title or Position | CREDENTIALING
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Name | CEMYIRA MCDOUGAL
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Credential |
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Telephone | 217-764-8609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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