MEDICARE: COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1376486860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.

Provider Business Mailing Address
First Line	:	1915 CHENEY HWY
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32780-6021
Country	:	US
Telephone Number	:	321-483-0355
Fax Number	:	321-483-0301

Provider Business Practice Location Address
First Line	:	1915 CHENEY HWY
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32780-6021
Country	:	US
Telephone Number	:	321-483-0355
Fax Number	:	321-483-0301

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	CEMYIRA MCDOUGAL
Credential	:
Telephone Number	:	217-764-8609

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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