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7255 Kathleen Rd Lakeland FL 33810-4722 | |
| (863) 274-3410 | |
| (863) 450-4820 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7255 Kathleen Rd, Lakeland, 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 |
|---|---|
7255 Kathleen Rd Lakeland FL 33810-4722 Ph: (863) 274-3410 | 7255 Kathleen Rd Lakeland FL 33810-4722 Ph: (863) 274-3410 |
| NPI Number | 1013534023 |
|---|---|
| Provider Enumeration Date | 06/26/2020 |
| Last Update Date | 01/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013534023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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