| Southeast Dental Group | |
|
5963 Se Federal Hwy Stuart FL 34997-7871 | |
| (772) 283-5360 | |
| Not Available |
| Full Name | Southeast Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5963 Se Federal Hwy, Stuart, Florida |
| Authorized Official Name and Position | Kam Shick (INSURANCE/CREDENTIALING) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Dental Group 5963 Se Federal Hwy Stuart FL 34997-7871 Ph: (772) 283-5360 | Southeast Dental Group 5963 Se Federal Hwy Stuart FL 34997-7871 Ph: (772) 283-5360 |
| NPI Number | 1518290196 |
|---|---|
| Provider Enumeration Date | 09/14/2009 |
| Last Update Date | 09/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518290196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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