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DR. ATHAS NICHOLAS KOMETAS DMD

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1063663722

Individual Registrant:
DR. ATHAS NICHOLAS KOMETAS DMD
Gender: M
Sole Proprietor

Location and contact information for practice:
3162 S ATLANTIC AVE SUITE C DAYTONA BEACH SHORES, FL 32118-6286 US
Tel: 386-760-0030  Fax: 386-788-3873

Contact information for business:
3162 S ATLANTIC AVE SUITE C DAYTONA BEACH SHORES, FL 32118-6286 US
Tel: 386-760-0030  Fax: 386-788-3873

Registration Information:
NPI: 1063663722
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
FLDN11431

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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