| Mount Dora Dental & Dentures | |
|
2781 W Old Highway 441 #24a Mount Dora FL 32757 | |
| (352) 385-1971 | |
| (352) 729-2239 |
| Full Name | Mount Dora Dental & Dentures |
|---|---|
| Speciality | Dentist |
| Location | 2781 W Old Highway 441, Mount Dora, Florida |
| Authorized Official Name and Position | Sook Ja Kim (OWNER) |
| Authorized Official Contact | 3523851971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mount Dora Dental & Dentures 2781 W Old Highway 441 #24a Mount Dora FL 32757 Ph: (352) 385-1971 | Mount Dora Dental & Dentures 2781 W Old Highway 441 #24a Mount Dora FL 32757 Ph: (352) 385-1971 |
| NPI Number | 1033372958 |
|---|---|
| Provider Enumeration Date | 07/10/2008 |
| Last Update Date | 02/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033372958 | NPI | - | NPPES |
| 002879200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14970 (Florida) | Primary |
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