Provider Demographics
NPI:1023602315
Name:DENTAL BUDDIES OF VERO BEACH
Entity type:Organization
Organization Name:DENTAL BUDDIES OF VERO BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYSONET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-569-4118
Mailing Address - Street 1:3755 7TH TER STE 303
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6547
Mailing Address - Country:US
Mailing Address - Phone:772-226-6888
Mailing Address - Fax:
Practice Address - Street 1:3755 7TH TER STE 303
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6547
Practice Address - Country:US
Practice Address - Phone:772-226-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty