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625 N Us Highway 441 Lady Lake FL 32159-3714 | |
| (352) 633-8082 | |
| (352) 268-2114 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 625 N Us Highway 441, Lady Lake, Florida |
| Authorized Official Name and Position | Jessica Britt (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
625 N Us Highway 441 Lady Lake FL 32159-3714 Ph: (352) 633-8082 | 625 N Us Highway 441 Lady Lake FL 32159-3714 Ph: (352) 633-8082 |
| NPI Number | 1376158030 |
|---|---|
| Provider Enumeration Date | 09/10/2020 |
| Last Update Date | 01/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376158030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Lady Lake Dental Care, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13915 N Us Highway 441, Lady Lake, FL 32159 Phone: 352-753-6365 Fax: 352-753-9865 | |