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General NPI Number Information
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NPI Number | 1770912537
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Entity Type | Organization
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Legal Business Name | BAY AREA DENTAL SLEEP ASSOCIATES
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 11/02/2013
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Provider Practice Location Address
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Address Line | 2467 ENTERPRISE RD SUITE F
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City | CLEARWATER
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State | FL
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Zip | 33763-1724
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Country | US
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Telephone | 727-791-0139
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Fax |
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Provider Business Mailing Address
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Address Line | 2467 ENTERPRISE RD SUITE F
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City | CLEARWATER
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State | FL
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Zip | 33763-1724
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Country | US
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Telephone | 727-791-0139
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY R PRIOR
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Credential | D.D.S.
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Telephone | 727-791-0139
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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 | BN15893
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License Number State | FL
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