Provider Demographics
NPI:1124534524
Name:DR JEFFREY BARTLETT & ASSOCIATES INC
Entity Type:Organization
Organization Name:DR JEFFREY BARTLETT & ASSOCIATES INC
Other - Org Name:DREAM SMILE CENTER.COM
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-566-8668
Mailing Address - Street 1:2330 NE 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-3579
Mailing Address - Country:US
Mailing Address - Phone:954-566-8668
Mailing Address - Fax:954-566-8679
Practice Address - Street 1:2330 NE 9TH STREET
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3579
Practice Address - Country:US
Practice Address - Phone:954-566-8668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL95401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty