| 113th Street Seminole Dental Llc | |
|
8500 113th St Suite B Seminole FL 33772-4126 | |
| (727) 392-3900 | |
| Not Available |
| Full Name | 113th Street Seminole Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 8500 113th St, Seminole, Florida |
| Authorized Official Name and Position | William Layman (OWNER) |
| Authorized Official Contact | 7273923900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 113th Street Seminole Dental Llc 8500 113th St Suite B Seminole FL 33772-4126 Ph: (727) 392-3900 | 113th Street Seminole Dental Llc 8500 113th St Suite B Seminole FL 33772-4126 Ph: (727) 392-3900 |
| NPI Number | 1598138679 |
|---|---|
| Provider Enumeration Date | 11/11/2015 |
| Last Update Date | 11/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598138679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 15686 (Florida) | Primary |
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