Provider Demographics
NPI:1922181536
Name:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Entity Type:Organization
Organization Name:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Other - Org Name:NATURE COAST DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:353-683-2283
Mailing Address - Street 1:11119 HEARTH RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-3727
Mailing Address - Country:US
Mailing Address - Phone:352-683-2283
Mailing Address - Fax:352-683-5504
Practice Address - Street 1:11119 HEARTH RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3727
Practice Address - Country:US
Practice Address - Phone:352-683-2283
Practice Address - Fax:352-683-5504
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty