Provider Demographics
NPI:1821533464
Name:STUART DENTAL CARE, LLC
Entity Type:Organization
Organization Name:STUART DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOHL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:772-287-3010
Mailing Address - Street 1:853 SE MONTEREY BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3337
Mailing Address - Country:US
Mailing Address - Phone:772-287-3010
Mailing Address - Fax:772-220-8218
Practice Address - Street 1:853 SE MONTEREY BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3337
Practice Address - Country:US
Practice Address - Phone:772-287-3010
Practice Address - Fax:772-220-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8393332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment