| Southern Dental LLC | |
|
2560 Maguire Rd Ocoee FL 34761-4749 | |
| (407) 656-5700 | |
| Not Available |
| Full Name | Southern Dental LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2560 Maguire Rd, Ocoee, Florida |
| Authorized Official Name and Position | Cary Freeman (INSURANCE COUNSLER) |
| Authorized Official Contact | 4076565700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Dental LLC 2560 Maguire Rd Ocoee FL 34761-4749 Ph: (407) 656-5700 | Southern Dental LLC 2560 Maguire Rd Ocoee FL 34761-4749 Ph: (407) 656-5700 |
| NPI Number | 1710004171 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710004171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN12260 (Florida) | Primary |
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