MEDICARE: ASSOCIATES IN FAMILY DENTAL CARE PANAMA CITY

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1831302546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATES IN FAMILY DENTAL CARE PANAMA CITY

Provider Business Mailing Address
First Line	:	3518 E 15TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-5831
Country	:	US
Telephone Number	:	850-769-5443
Fax Number	:

Provider Business Practice Location Address
First Line	:	3518 E 15TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-5831
Country	:	US
Telephone Number	:	850-769-5443
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDRE KANDY
Credential	:	DDS
Telephone Number	:	850-769-5443

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	08/22/2020

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Directions to “ASSOCIATES IN FAMILY DENTAL CARE PANAMA CITY ” Practice Location

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