| Avalondental Group | |
|
12950 E Colonial Dr Ste 124 Orlando FL 32826-4609 | |
| (407) 281-1119 | |
| (407) 381-3711 |
| Full Name | Avalondental Group |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 12950 E Colonial Dr Ste 124, Orlando, Florida |
| Authorized Official Name and Position | Nga K Van (DENTIST) |
| Authorized Official Contact | 4072811119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avalondental Group 12950 E Colonial Dr Ste 124 Orlando FL 32826-4609 Ph: (407) 281-1119 | Avalondental Group 12950 E Colonial Dr Ste 124 Orlando FL 32826-4609 Ph: (407) 281-1119 |
| NPI Number | 1942556337 |
|---|---|
| Provider Enumeration Date | 08/03/2012 |
| Last Update Date | 08/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942556337 | NPI | - | NPPES |
| 003333500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | DN17986 (Florida) | Primary |
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