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1407330145
PROVIDENCE DENTAL LLC
ORLANDO, FL
NPI
1407330145
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Entity Type
Organization
Authorized Contact
NADIA KAHOOK
Credentialing Consultant
954-446-5797
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
Enumeration Date
2018-09-19
Last Update Date
2018-09-19
Business Address
PROVIDENCE DENTAL LLC
12450 E. COLONIAL DRIVE SUITE 124
ORLANDO, FL 32826
Phone number: 407-635-0704
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Mailing Address
PROVIDENCE DENTAL LLC
12450 E. COLONIAL DRIVE SUITE 124
ORLANDO, FL 32826
Phone number: 407-635-0704
Copy
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