| St. Lucie West Dental Care | |
|
1384 Sw St. Lucie Port St. Lucie FL 34986 | |
| (772) 380-4469 | |
| Not Available |
| Full Name | St. Lucie West Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1384 Sw St. Lucie, Port St. Lucie, Florida |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Lucie West Dental Care 1384 Sw St. Lucie West Port St. Lucie FL 34986 Ph: () - | St. Lucie West Dental Care 1384 Sw St. Lucie Port St. Lucie FL 34986 Ph: (772) 380-4469 |
| NPI Number | 1134514086 |
|---|---|
| Provider Enumeration Date | 03/30/2015 |
| Last Update Date | 04/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134514086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN20755 (Florida) | Primary |
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