NPI 1114285715 · live from the CMS NPI Registry
29 Dental
Dentist, General Practice in Pensacola, FL. National Provider Identifier 1114285715, active.
NPI record
| NPI | 1114285715 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 2850 Monroe St, Pensacola, FL 32514 |
| Practice phone | 850-484-4844 |
| Enumerated | May 2, 2012 |
| Last updated | May 2, 2012 |
| Authorized official | An Nguyen, Member |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | 17043 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.