Provider Demographics
NPI:1528216470
Name:CHURNEY DENTAL SERVICES, INC.
Entity Type:Organization
Organization Name:CHURNEY DENTAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-799-6733
Mailing Address - Street 1:28469 US HIGHWAY 19 N STE 401
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2512
Mailing Address - Country:US
Mailing Address - Phone:727-799-6733
Mailing Address - Fax:727-726-9157
Practice Address - Street 1:28469 US HIGHWAY 19 N STE 401
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2512
Practice Address - Country:US
Practice Address - Phone:727-799-6733
Practice Address - Fax:727-726-9157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN104641223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty