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General NPI Number Information
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NPI Number | 1770987190
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Entity Type | Organization
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Legal Business Name | STUART FAMILY DENTISTRY, INC.
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 2385 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-4528
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Country | US
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Telephone | 772-286-3088
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Fax | 772-287-5993
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Provider Business Mailing Address
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Address Line | 2385 SE FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-4528
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Country | US
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Telephone | 772-286-3088
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Fax | 772-287-5993
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DANIEL MARK CASEL
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Credential | DMD
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Telephone | 561-686-2077
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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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