| Winter Park Dentistry | |
|
865 Balch Ave Winter Park FL 32789-4917 | |
| (407) 629-2161 | |
| Not Available |
| Full Name | Winter Park Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 865 Balch Ave, Winter Park, Florida |
| Authorized Official Name and Position | Peter Kelly (OWNER) |
| Authorized Official Contact | 4103031528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Winter Park Dentistry 865 Balch Ave Winter Park FL 32789-4917 | Winter Park Dentistry 865 Balch Ave Winter Park FL 32789-4917 Ph: (407) 629-2161 |
| NPI Number | 1588290837 |
|---|---|
| Provider Enumeration Date | 03/19/2020 |
| Last Update Date | 03/19/2020 |
| Certification Date | 03/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588290837 | NPI | - | NPPES |
| DN19430 | Other | FL | STATE LICENSE |
| DN19627 | Other | FL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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