| Davenport Modern Dentistry, Pa | |
|
1159 Posner Blvd Davenport FL 33837-3664 | |
| (863) 777-9890 | |
| Not Available |
| Full Name | Davenport Modern Dentistry, Pa |
|---|---|
| Speciality | Dentist |
| Location | 1159 Posner Blvd, Davenport, Florida |
| Authorized Official Name and Position | Minh B Pham (OWNER/DDS) |
| Authorized Official Contact | 8637779890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Davenport Modern Dentistry, Pa Po Box 920050 Dallas TX 75392-0050 Ph: () - | Davenport Modern Dentistry, Pa 1159 Posner Blvd Davenport FL 33837-3664 Ph: (863) 777-9890 |
| NPI Number | 1568005999 |
|---|---|
| Provider Enumeration Date | 10/17/2019 |
| Last Update Date | 06/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568005999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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