Provider Demographics
NPI:1467795435
Name:BAYVIEW DENTAL HEALTH PROFESSIONALS
Entity Type:Organization
Organization Name:BAYVIEW DENTAL HEALTH PROFESSIONALS
Other - Org Name:BAYVIEW DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-536-6262
Mailing Address - Street 1:7442 N TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-1800
Mailing Address - Country:US
Mailing Address - Phone:941-536-6262
Mailing Address - Fax:941-359-8123
Practice Address - Street 1:7442 N TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-1800
Practice Address - Country:US
Practice Address - Phone:941-536-6262
Practice Address - Fax:941-359-8123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00109391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty