Bautista, Gregorio Wayne
Bautista, Gregorio Wayne is an individual health care provider with primary practice located at 909 E Oak St Ste A , Kissimmee FL 34744. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bautista, Gregorio Wayne can be contacted via phone (407) 847-2103.Contact Information
Primary practice address
909 E Oak St Ste A
Kissimmee FL 34744
Phone: (407) 847-2103
Fax: (407) 847-5042
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN13033 | Florida |
Profile Details
| NPI number | 1699950329 |
|---|---|
| LBN Legal business name | Bautista, Gregorio Wayne |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 31st, 2007 |
| Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699950329 | NPPES |
| Florida | MEDICAID | 017646700 |
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