Provider Demographics
NPI:1518718501
Name:INTEGRATIVE DENTISTRY OF SARASOTA
Entity Type:Organization
Organization Name:INTEGRATIVE DENTISTRY OF SARASOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BRANDAU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:941-921-0300
Mailing Address - Street 1:7129 CURTISS AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8080
Mailing Address - Country:US
Mailing Address - Phone:941-921-0300
Mailing Address - Fax:941-761-5121
Practice Address - Street 1:7129 CURTISS AVE STE 1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8080
Practice Address - Country:US
Practice Address - Phone:941-921-0300
Practice Address - Fax:941-761-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental