| Shore Lake Dental | |
|
1745 S Highland Ave # 6w Clearwater FL 33756-1852 | |
| (727) 586-1402 | |
| Not Available |
| Full Name | Shore Lake Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1745 S Highland Ave # 6w, Clearwater, Florida |
| Authorized Official Name and Position | Brandon Bohrer (OWNER) |
| Authorized Official Contact | 5855072684 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Lake Dental 215 Orange St Palm Harbor FL 34683-5224 | Shore Lake Dental 1745 S Highland Ave # 6w Clearwater FL 33756-1852 Ph: (727) 586-1402 |
| NPI Number | 1073269494 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 02/24/2022 |
| Certification Date | 02/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073269494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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