| Advanced Dental Inc. | |
|
1525 Herbert St Suite 101 Port Orange FL 32129-6106 | |
| (386) 322-7786 | |
| (386) 761-3920 |
| Full Name | Advanced Dental Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1525 Herbert St, Port Orange, Florida |
| Authorized Official Name and Position | Luis O. Soto (PRESIDENT) |
| Authorized Official Contact | 3863227786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Inc. 1525 Herbert St Suite 101 Port Orange FL 32129-6106 Ph: (386) 322-7786 | Advanced Dental Inc. 1525 Herbert St Suite 101 Port Orange FL 32129-6106 Ph: (386) 322-7786 |
| NPI Number | 1669503264 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669503264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN12614 (Florida) | Primary |
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