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2304 Lakeland Hills Blvd Lakeland FL 33805-2910 | |
| (863) 682-1500 | |
| (863) 682-6318 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2304 Lakeland Hills Blvd, Lakeland, Florida |
| Authorized Official Name and Position | Michael F Agnini (OWNER/PRESIDENT) |
| Authorized Official Contact | 8636821500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2304 Lakeland Hills Blvd Lakeland FL 33805-2910 Ph: (863) 682-1500 | 2304 Lakeland Hills Blvd Lakeland FL 33805-2910 Ph: (863) 682-1500 |
| NPI Number | 1851568182 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 05/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851568182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN5964 (Florida) | Primary |
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