| Sage Dental Of Port St Lucie West, Pllc | |
|
1722 Sw Saint Lucie West Blvd Port St Lucie FL 34986-2504 | |
| (772) 337-8600 | |
| (561) 431-8169 |
| Full Name | Sage Dental Of Port St Lucie West, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1722 Sw Saint Lucie West Blvd, Port St Lucie, Florida |
| Authorized Official Name and Position | Antonio Cruz (CHIEF DENTAL DIRECTOR) |
| Authorized Official Contact | 5619999650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Dental Of Port St Lucie West, Pllc 951 Broken Sound Pkwy Suite 250 Boca Raton FL 33487 Ph: (561) 999-9650 | Sage Dental Of Port St Lucie West, Pllc 1722 Sw Saint Lucie West Blvd Port St Lucie FL 34986-2504 Ph: (772) 337-8600 |
| NPI Number | 1205193539 |
|---|---|
| Provider Enumeration Date | 04/11/2012 |
| Last Update Date | 04/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205193539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN6483 (Florida) | Primary |
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