ELLENTON FAMILY DENTAL CORP NPI 1184092629

NPI Information

ELLENTON FAMILY DENTAL CORP is a dental clinic center in Ellenton, FL. ELLENTON FAMILY DENTAL CORP NPI is 1184092629. The provider is registered as an organization entity type.

The provider's business location address is:

5975 FACTORY SHOPS BLVD
ELLENTON, FL
ZIP 34222-125
Phone: (941) 479-7936
Fax: (941) 479-7991

The provider's authorized official is Carla M Mathews .
The authorized official title is Office Manager and has the following contact phone number (941) 479-7936.

The enumeration date for this NPI number is 9/14/2015 and was last updated on 9/14/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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