| NPI | 1699072330 |
|---|---|
| Doing Business As | BAY DENTAL SPECIALISTS |
| Entity Type | Organization |
| Authorized Contact | BRIAN M. BIVENS President 813-443-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: FL DN16668) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics (Licence: FL DN6295) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist (Licence: FL DH15021) | |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |