| Advanced Orthodontics Of America, Llc | |
|
2202 State Ave Ste 200 Panama City FL 32405-4582 | |
| (850) 769-2722 | |
| Not Available |
| Full Name | Advanced Orthodontics Of America, Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2202 State Ave Ste 200, Panama City, Florida |
| Authorized Official Name and Position | Lauren Kovaleski (MANAGER) |
| Authorized Official Contact | 8507692722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Orthodontics Of America, Llc 2202 State Ave Ste 200 Panama City FL 32405-4582 Ph: () - | Advanced Orthodontics Of America, Llc 2202 State Ave Ste 200 Panama City FL 32405-4582 Ph: (850) 769-2722 |
| NPI Number | 1881137842 |
|---|---|
| Provider Enumeration Date | 11/23/2016 |
| Last Update Date | 11/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881137842 | NPI | - | NPPES |
| 007329900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DN19214 (Florida) | Primary |
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