Provider Demographics
NPI:1972702611
Name:WINTERMAN, BRIAN S (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:WINTERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3575 SW 30TH WAY
Mailing Address - Street 2:APT 120
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-2737
Mailing Address - Country:US
Mailing Address - Phone:954-295-3933
Mailing Address - Fax:
Practice Address - Street 1:2760 SE 17TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5571
Practice Address - Country:US
Practice Address - Phone:352-867-7797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18110122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist