| Manatee Endodontics | |
|
2111 59th St W Bradenton FL 34209-7015 | |
| (941) 792-4166 | |
| (941) 792-5435 |
| Full Name | Manatee Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 2111 59th St W, Bradenton, Florida |
| Authorized Official Name and Position | L. Carl De Jongh (PRESIDENT) |
| Authorized Official Contact | 9417924166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manatee Endodontics 2111 59th St W Bradenton FL 34209-7015 Ph: (941) 792-4166 | Manatee Endodontics 2111 59th St W Bradenton FL 34209-7015 Ph: (941) 792-4166 |
| NPI Number | 1508995242 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508995242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | DN 5742 (Florida) | Primary |
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