MEDICAID DENTISTRY OF DAYTONA LLC

DAYTONA BEACH, FL
NPI1326470436
Other NameDAYTONA PEDIATRIC DENTISTRY
Entity TypeOrganization
Authorized ContactMUBASHIR CHAUDHRY
Owner
386-304-2677
Organization Subpart ?No
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: FL  DN13783)
Additional Taxonomies122300000X Dentist
1223P0221X Dentist, Pediatric Dentistry
(Licence: FL  DN18742)
Enumeration Date2013-07-31
Last Update Date2018-05-21
Business Address
MEDICAID DENTISTRY OF DAYTONA LLC
1021 SOUTH RIDGEWOOD AVE
DAYTONA BEACH, FL 32114
Phone number: 386-304-2677
Mailing Address
MEDICAID DENTISTRY OF DAYTONA LLC
1021 SOUTH RIDGEWOOD AVE
DAYTONA BEACH, FL 32114
Phone number: 386-304-2677