| Victus Dental Ii Pa | |
|
1308 West 9 Mile Rd Suite 9 Penscola FL 32534-3253 | |
| (850) 484-4844 | |
| Not Available |
| Full Name | Victus Dental Ii Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1308 West 9 Mile Rd Suite 9, Penscola, Florida |
| Authorized Official Name and Position | Anthony Le (PRESIDENT) |
| Authorized Official Contact | 2013753363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victus Dental Ii Pa 2850 Monroe St Ste B Pensacola FL 32514-7656 Ph: () - | Victus Dental Ii Pa 1308 West 9 Mile Rd Suite 9 Penscola FL 32534-3253 Ph: (850) 484-4844 |
| NPI Number | 1467917823 |
|---|---|
| Provider Enumeration Date | 02/09/2019 |
| Last Update Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467917823 | NPI | - | NPPES |
| 025098900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |