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1629598750
GENESIS DENTAL GROUP SMILES ON 11TH LLC
PANAMA CITY, FL
NPI
1629598750
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Entity Type
Organization
Authorized Contact
SUSAN STEWART
Manager
334-676-2320
Organization Subpart ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
Enumeration Date
2017-06-20
Last Update Date
2017-06-20
Business Address
GENESIS DENTAL GROUP SMILES ON 11TH LLC
1010 W 11TH ST
PANAMA CITY, FL 32401-2042
Phone number: 850-763-3622
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Mailing Address
GENESIS DENTAL GROUP SMILES ON 11TH LLC
3150 ZELDA CT
MONTGOMERY, AL 36106-2607
Phone number: 334-676-2320
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