Potempa, Phil
Potempa, Phil is an individual health care provider with primary practice located at 1100 Loveland Blvd , Port Charlotte FL 33980. He recently has only one registered license in Dental Providers / Dental Public Health, which is considered as his primary health care specialty. Potempa, Phil can be contacted via phone (941) 624-7200.Contact Information
Primary practice address
1100 Loveland Blvd
Port Charlotte FL 33980
Phone: (941) 624-7200
Fax: (941) 624-7274
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Public Health | 1223D0001X | DN17474 | Florida |
Profile Details
| NPI number | 1811099062 |
|---|---|
| LBN Legal business name | Potempa, Phil |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Dec 16th, 2016 - about 9 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 | 1811099062 | NPPES |
| Florida | MEDICAID | 02792420411 | |
| Florida | MEDICAID | 076162100 | |
| Florida | Other | P351679422910 |
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