| Orthodontic Professional Services | |
|
1813 Se Port St Lucie Blvd Port St Lucie FL 34952-5544 | |
| (772) 528-3434 | |
| Not Available |
| Full Name | Orthodontic Professional Services |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1813 Se Port St Lucie Blvd, Port St Lucie, Florida |
| Authorized Official Name and Position | Marcela Matamoros (PRESIDENT) |
| Authorized Official Contact | 7725283434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthodontic Professional Services 1813 Se Port St Lucie Blvd Port St Lucie FL 34952-5544 Ph: () - | Orthodontic Professional Services 1813 Se Port St Lucie Blvd Port St Lucie FL 34952-5544 Ph: (772) 528-3434 |
| NPI Number | 1669977203 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 03/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669977203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DN20300 (Florida) | Primary |
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