Provider Demographics
NPI:1275702953
Name:SEAN M GASSETT, D.MD., P.A.
Entity Type:Organization
Organization Name:SEAN M GASSETT, D.MD., P.A.
Other - Org Name:APOLLO BEACH DENTAL EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-341-0102
Mailing Address - Street 1:433 APOLLO BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2281
Mailing Address - Country:US
Mailing Address - Phone:813-341-0102
Mailing Address - Fax:
Practice Address - Street 1:433 APOLLO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2281
Practice Address - Country:US
Practice Address - Phone:813-341-0102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty