| Lake Village Dental | |
|
3261 S Us Highway 27 # 441e-1 Fruitland Park FL 34731-4497 | |
| (352) 314-2729 | |
| (352) 314-9889 |
| Full Name | Lake Village Dental |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 3261 S Us Highway 27 # 441e-1, Fruitland Park, Florida |
| Authorized Official Name and Position | Vamsi Kallepalli (DENTIST) |
| Authorized Official Contact | 3523142729 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Village Dental 3261 S Us Highway 27 # 441e-1 Fruitland Park FL 34731-4497 Ph: (352) 314-2729 | Lake Village Dental 3261 S Us Highway 27 # 441e-1 Fruitland Park FL 34731-4497 Ph: (352) 314-2729 |
| NPI Number | 1760073217 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 01/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760073217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |