GENESIS DENTAL GROUP SMILES ON 11TH LLC

PANAMA CITY, FL
NPI1629598750
Entity TypeOrganization
Authorized ContactSUSAN STEWART
Manager
334-676-2320
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
Enumeration Date2017-06-20
Last Update Date2017-06-20
Business Address
GENESIS DENTAL GROUP SMILES ON 11TH LLC
1010 W 11TH ST
PANAMA CITY, FL 32401-2042
Phone number: 850-763-3622
Mailing Address
GENESIS DENTAL GROUP SMILES ON 11TH LLC
3150 ZELDA CT
MONTGOMERY, AL 36106-2607
Phone number: 334-676-2320