| NPI | 1568280519 |
|---|---|
| Doing Business As | AMERICAN DENTAL OF LAGRANGE |
| Entity Type | Organization |
| Authorized Contact | NICOLE CARIDE Credentialing Manager 727-784-2721 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |