Provider Demographics
NPI:1134201239
Name:NASH, BERNARD G (DMD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:G
Last Name:NASH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 W SAND LAKE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5198
Mailing Address - Country:US
Mailing Address - Phone:407-226-3350
Mailing Address - Fax:407-226-3352
Practice Address - Street 1:7800 W SAND LAKE RD STE 220
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5198
Practice Address - Country:US
Practice Address - Phone:407-226-3350
Practice Address - Fax:407-226-3352
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 111331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice