Look up the most recent NPI and PECOS records

C. Nicholas Deture Pa

(<Unavail>)

Dentist

Dental Providers

901 SE Ocean Blvd, Stuart, FL 34994-2429

PECOS Enrollment

Based on the most recent information from CMS, provider C. Nicholas Deture Pa does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1457893745
Provider Type
Organization
Full Name
C. Nicholas Deture Pa
Other Name
<Unavail>

Subpart
No
Enumeration Date
11/17/2016
Last Updated
11/17/2016

Contact Information

Practice Location

901 SE Ocean Blvd, Stuart, FL 34994-2429

(772) 283-1400

(772) 283-1488

Mailing Location

901 SE Ocean Blvd, Stuart, FL 34994-2429

(772) 283-1400

(772) 283-1488

Authorized Official

Deture, Nicolas (Doctor/Provider)

(772) 283-1400

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License Unlisted Issuer

C. Nicholas Deture Pa

(<Unavail>)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Riggs, Crystel Ananos

Flanary, Robert C

Batista Rodriguez, Wendy

Jaffe, Eric Neil

Ford, Inge B

Tyson, John T

Medwid, Rita

Sage Dental Of Jensen Beach, Pllc

Jackson, David Creston

Baselious, Meriam Micheal