| Fl Southern Dental Pa | |
|
382 N Causeway New Smyrna Beach FL 32169-5233 | |
| (386) 428-6468 | |
| Not Available |
| Full Name | Fl Southern Dental Pa |
|---|---|
| Speciality | Dentist |
| Location | 382 N Causeway, New Smyrna Beach, Florida |
| Authorized Official Name and Position | Erika Melissa Menjivar (SR. CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4695966137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fl Southern Dental Pa 5830 Granite Pkwy Ste 780 Plano TX 75024-6775 Ph: () - | Fl Southern Dental Pa 382 N Causeway New Smyrna Beach FL 32169-5233 Ph: (386) 428-6468 |
| NPI Number | 1720970569 |
|---|---|
| Provider Enumeration Date | 07/16/2025 |
| Last Update Date | 07/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720970569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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