| Coast Dental-ormond Beach | |
|
378 W Granada Blvd Ormond Beach FL 32174-6274 | |
| (386) 672-5595 | |
| (386) 672-5597 |
| Full Name | Coast Dental-ormond Beach |
|---|---|
| Speciality | Dentist |
| Location | 378 W Granada Blvd, Ormond Beach, Florida |
| Authorized Official Name and Position | Melody Rivera (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8133507166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coast Dental-ormond Beach 5706 Benjamin Center Dr Ste 103 Tampa FL 33634-5262 Ph: (813) 288-1999 | Coast Dental-ormond Beach 378 W Granada Blvd Ormond Beach FL 32174-6274 Ph: (386) 672-5595 |
| NPI Number | 1265008676 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 05/27/2021 |
| Certification Date | 05/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265008676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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