FL SOUTHERN DENTAL PPO PA

LAKE MARY, FL
NPI1841096799
Entity TypeOrganization
Authorized ContactERIKA MELISSA MENJIVAR
Sr. Credentialing Specialist
469-596-6137
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2025-02-21
Last Update Date2025-02-21
Business Address
FL SOUTHERN DENTAL PPO PA
4106 W LAKE MARY BLVD STE 230
LAKE MARY, FL 32746-2403
Phone number: 407-333-0881
Mailing Address
FL SOUTHERN DENTAL PPO PA
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number:
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