Provider Demographics
NPI:1245593722
Name:SANFORD GENTLE DENTISTRY
Entity Type:Organization
Organization Name:SANFORD GENTLE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANTZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGNOL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-323-2220
Mailing Address - Street 1:233 BELLAGIO CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5001
Mailing Address - Country:US
Mailing Address - Phone:407-323-2202
Mailing Address - Fax:407-323-2224
Practice Address - Street 1:233 BELLAGIO CIR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-5001
Practice Address - Country:US
Practice Address - Phone:407-323-2202
Practice Address - Fax:407-323-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16670261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental