| Dietrich Dental Services Pa | |
|
17178 Toledo Blade Blvd Port Charlotte FL 33954-2626 | |
| (941) 625-7877 | |
| (941) 625-4349 |
| Full Name | Dietrich Dental Services Pa |
|---|---|
| Speciality | Dentist |
| Location | 17178 Toledo Blade Blvd, Port Charlotte, Florida |
| Authorized Official Name and Position | John Louis Dietrich (PRESIDENT) |
| Authorized Official Contact | 9416257877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dietrich Dental Services Pa 17178 Toledo Blade Blvd Port Charlotte FL 33954-2626 Ph: (941) 625-7877 | Dietrich Dental Services Pa 17178 Toledo Blade Blvd Port Charlotte FL 33954-2626 Ph: (941) 625-7877 |
| NPI Number | 1003185240 |
|---|---|
| Provider Enumeration Date | 12/16/2011 |
| Last Update Date | 12/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003185240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN9422 (Florida) | Primary |
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