Provider Demographics
NPI:1720327125
Name:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.B.
Entity Type:Organization
Organization Name:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.B.
Other - Org Name:BRADENTON SMILES DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURNACE/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-5100
Mailing Address - Street 1:8605 E STATE ROAD 70
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-3707
Mailing Address - Country:US
Mailing Address - Phone:941-538-6437
Mailing Address - Fax:
Practice Address - Street 1:8605 E STATE ROAD 70
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-3707
Practice Address - Country:US
Practice Address - Phone:941-538-6437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.B.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty