Provider Demographics
NPI:1467908871
Name:A2Z GENTLE DENTISTRY CORP
Entity Type:Organization
Organization Name:A2Z GENTLE DENTISTRY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:772-287-8225
Mailing Address - Street 1:5761 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-8545
Mailing Address - Country:US
Mailing Address - Phone:772-287-8225
Mailing Address - Fax:
Practice Address - Street 1:5761 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-8545
Practice Address - Country:US
Practice Address - Phone:772-287-8225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty