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General NPI Number Information
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NPI Number | 1700183035
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Entity Type | Organization
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Legal Business Name | GLORI ENZOR, DDS, PA
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 3220 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34239-5102
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Country | US
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Telephone | 941-365-3222
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Fax | 941-365-3226
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Provider Business Mailing Address
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Address Line | 3220 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34239-5102
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Country | US
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Telephone | 941-365-3222
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Fax | 941-365-3226
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. GLORI A ENZOR
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Credential | DDS
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Telephone | 941-365-3222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 14434
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License Number State | FL
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