Bluewater Bay Dental, PA
Organization Active NPI General Practice Dentistry · Niceville, FL
NPI 1104294669 · NPPES record last updated Mar 4, 2022
Key facts
- NPI
- 1104294669
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN15111 (FL)
- Legal business name
- BLUEWATER BAY DENTAL, PA
- Practice address
- 4400 E Highway 20 Ste 101
Niceville, FL 32578-9735 - Phone
- (850) 897-4488
- NPI assigned
- Sep 14, 2015
- Organization subpart
- No
Authorized official
- Name
- Olivier Broutin
- Title
- Director
- Phone
- (850) 897-4488
Practitioners 1
-
Olivier Broutin, D.M.D.
National Provider Directory
Locations
4400 E Highway 20
Ste 101
Niceville, FL 32578
Phone (850) 897-4488
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | DN15111 | FL | Yes |
Addresses
Primary practice location
4400 E Highway 20 Ste 101
Niceville, FL 32578-9735
Mailing address
4400 E Highway 20 Ste 101
Niceville, FL 32578-9735
Phone (850) 897-4488
Other names
- Smileology
Other providers in Niceville, FL
- Allyson Blackburn
- George Ryan Blackman
- Caroline Blauvelt
- Melissa Blizzard
- Blue Sky DME Inc
- Bluewater Bay Urology LLC
- Bluewater Behavioral Health Inc
- Bluewater Behavioral Services
- Bluewater Behavioral Services
- Bluewater Cardiology LLC
All providers in Niceville, FL · General Practice Dentistry in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.