| Dentist Of Lake Mary Llc | |
|
229 Wheelhouse Ln Ste 1241 Lake Mary FL 32746-3665 | |
| (407) 284-1645 | |
| Not Available |
| Full Name | Dentist Of Lake Mary Llc |
|---|---|
| Speciality | Dentist |
| Location | 229 Wheelhouse Ln Ste 1241, Lake Mary, Florida |
| Authorized Official Name and Position | Dharam Pal Tayal (MEMBER) |
| Authorized Official Contact | 7162395889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentist Of Lake Mary Llc 12250 Strategy Blvd Ste 437 Orlando FL 32817-2108 Ph: (407) 284-1645 | Dentist Of Lake Mary Llc 229 Wheelhouse Ln Ste 1241 Lake Mary FL 32746-3665 Ph: (407) 284-1645 |
| NPI Number | 1124622659 |
|---|---|
| Provider Enumeration Date | 11/25/2020 |
| Last Update Date | 11/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124622659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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