Individual provider · Type 1 NPI

Phennatda Polpornvitoon

General Practice Dentistry · Port Charlotte, FL

NPI number 1568082030 Active

Practice location

18000 Toledo Blade Blvd
Port Charlotte, FL 33948-1980

Call (941) 740-8598 Map

Other practice locations

  • 801 S Paulina St Rm 110, Chicago, IL 60612-7210 · (312) 996-1052

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000XDN25388 (FL)
General Practice Dentistry Primary 1223G0001XDN25388 (FL)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

5 other providers at this address

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About NPI 1568082030

Phennatda Polpornvitoon's National Provider Identifier is 1568082030, issued on Apr 24, 2020. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Port Charlotte, FL. The record was last updated on Jun 10, 2022.