Provider Demographics
NPI:1629951926
Name:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Entity type:Organization
Organization Name:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CEMYIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-764-8609
Mailing Address - Street 1:9163 BABCOCK ST SE
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:FL
Mailing Address - Zip Code:32909-1453
Mailing Address - Country:US
Mailing Address - Phone:321-490-1735
Mailing Address - Fax:321-490-1738
Practice Address - Street 1:9163 BABCOCK ST SE
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:FL
Practice Address - Zip Code:32909-1453
Practice Address - Country:US
Practice Address - Phone:321-490-1735
Practice Address - Fax:321-490-1738
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty