Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Panama City Beach Center for Cosmetic & Family Destistry

Organization Dentist · NPI 1275951717

Panama City Beach Center for Cosmetic & Family Destistry provides Dentist services in Panama City Beach, Florida. Licensed in Florida. Registered with an NPI since 2014.

Licensed in
FL
In the registry since
2014
Specialties on file
3

Practice location Address checks out

309 N Richard Jackson Blvd
Panama City Beach, FL 32407-3695 Not confirmed with CMS for 12 years — call before visiting
Phone: (850) 235-2299
Fax: (850) 334-9017
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 0014608 (FL)
Dentist Taxonomy 122300000X · Licence DN19333 (FL)
Dentist Taxonomy 122300000X · Licence DN19829 (FL)

Record details

NPI number1275951717
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dennis Lichorwic — Owner/ President · (850) 654-8665
NPI enumeratedApril 2, 2014
Last updated in NPPESApril 2, 2014
Mailing address4635 Gulfstarr Dr, Destin, FL 32541-5780

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