| Main Street Children's Dentistry And Orthodontics Of Orange City, P.a. | |
|
2435 S Volusia Ave Ste D2 Orange City FL 32763-7643 | |
| (386) 775-0833 | |
| Not Available |
| Full Name | Main Street Children's Dentistry And Orthodontics Of Orange City, P.a. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2435 S Volusia Ave Ste D2, Orange City, Florida |
| Authorized Official Name and Position | Stephanie Gomez (PROVIDER RELATIONS SPECIALIST) |
| Authorized Official Contact | 3052742499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Children's Dentistry And Orthodontics Of Orange City, P.a. 13195 Sw 134th St Fl 2 Miami FL 33186-4461 Ph: (305) 274-2499 | Main Street Children's Dentistry And Orthodontics Of Orange City, P.a. 2435 S Volusia Ave Ste D2 Orange City FL 32763-7643 Ph: (386) 775-0833 |
| NPI Number | 1124393822 |
|---|---|
| Provider Enumeration Date | 03/13/2012 |
| Last Update Date | 03/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124393822 | NPI | - | NPPES |
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Terrence Soule, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2578 S Volusia Ave, Orange City, FL 32763 Phone: 386-775-1552 | |
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