| Fl Southern Dental Ppo Pa | |
|
1100 N Kentucky Ave Winter Park FL 32789-4741 | |
| (407) 647-6261 | |
| Not Available |
| Full Name | Fl Southern Dental Ppo Pa |
|---|---|
| Speciality | Dentist |
| Location | 1100 N Kentucky Ave, Winter Park, 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 Ppo Pa 5830 Granite Pkwy Ste 780 Plano TX 75024-6775 Ph: () - | Fl Southern Dental Ppo Pa 1100 N Kentucky Ave Winter Park FL 32789-4741 Ph: (407) 647-6261 |
| NPI Number | 1679379523 |
|---|---|
| Provider Enumeration Date | 02/21/2025 |
| Last Update Date | 02/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679379523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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Endodontic Associates Of Orlando, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Lee Rd Ste A, Winter Park, FL 32789 Phone: 407-647-2131 Fax: 407-645-5161 | |
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