Provider Demographics
NPI:1841574845
Name:MEADOWS FAMILY CARE CENTERS
Entity Type:Organization
Organization Name:MEADOWS FAMILY CARE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:941-745-1143
Mailing Address - Street 1:9912 E STATE ROAD 64
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-5303
Mailing Address - Country:US
Mailing Address - Phone:941-745-1143
Mailing Address - Fax:941-708-0555
Practice Address - Street 1:9912 E STATE ROAD 64
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-5303
Practice Address - Country:US
Practice Address - Phone:941-745-1143
Practice Address - Fax:941-708-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL163941223P0221X
FL192431223P0221X
FL193661223P0221X
FL166971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty