Provider Demographics
NPI:1760519953
Name:PRASATTHONG, DAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:PRASATTHONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 SILVERTHORN RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-3160
Mailing Address - Country:US
Mailing Address - Phone:727-398-5459
Mailing Address - Fax:727-345-6551
Practice Address - Street 1:7701 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1234
Practice Address - Country:US
Practice Address - Phone:727-345-3151
Practice Address - Fax:727-345-6551
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL137691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry