Organization · Type 2 NPI
Divergent Dental Group, LLC
Dental Clinic/Center · Englewood, FL
NPI number
1497379259
Active
Practice location
1861 Placida Rd Ste 105
Englewood, FL 34223-4900
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Another provider at this address
About NPI 1497379259
Divergent Dental Group, LLC's National Provider Identifier is 1497379259, issued on Jun 7, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Englewood, FL. The record was last updated on Jun 10, 2020.