| Sand Mine Dentistry, Pllc | |
|
49591 Highway 27 Ste 301 Davenport FL 33897-9507 | |
| (6) - | |
| Not Available |
| Full Name | Sand Mine Dentistry, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 49591 Highway 27 Ste 301, Davenport, Florida |
| Authorized Official Name and Position | Peter Kelly (OWNER) |
| Authorized Official Contact | 4074326224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sand Mine Dentistry, Pllc 49591 Highway 27 Ste 301 Davenport FL 33897-9507 Ph: (6) - | Sand Mine Dentistry, Pllc 49591 Highway 27 Ste 301 Davenport FL 33897-9507 Ph: (6) - |
| NPI Number | 1255025235 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255025235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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