FL SOUTHERN DENTAL PPO PA

DAVIE, FL
NPI1124817754
Doing Business AsDAVIE FAMILY DENTAL
Entity TypeOrganization
Authorized ContactERIKA MELISSA MENJIVAR
Sr. Credentialing Specialist
469-596-6137
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2025-05-01
Last Update Date2025-05-01
Business Address
FL SOUTHERN DENTAL PPO PA
4745 SW 148TH AVE
DAVIE, FL 33330-2126
Phone number: 954-349-3449
Mailing Address
FL SOUTHERN DENTAL PPO PA
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number: