| Debary Dentistry Llc | |
|
190 N Charles Richard Beall Blvd Ste 101 Debary FL 32713-2271 | |
| (386) 668-2003 | |
| Not Available |
| Full Name | Debary Dentistry Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 190 N Charles Richard Beall Blvd Ste 101, Debary, Florida |
| Authorized Official Name and Position | Peter Kelly (OWNER) |
| Authorized Official Contact | 4103031528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Debary Dentistry Llc 190 N Charles Richard Beall Blvd Ste 101 Debary FL 32713-2271 Ph: (386) 668-2003 | Debary Dentistry Llc 190 N Charles Richard Beall Blvd Ste 101 Debary FL 32713-2271 Ph: (386) 668-2003 |
| NPI Number | 1366078750 |
|---|---|
| Provider Enumeration Date | 03/17/2020 |
| Last Update Date | 03/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366078750 | NPI | - | NPPES |
| DN19430 | Other | FL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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