| Genesis Dental Group Smiles On 11th Llc | |
|
1010 W 11th St Panama City FL 32401-2042 | |
| (850) 763-3622 | |
| Not Available |
| Full Name | Genesis Dental Group Smiles On 11th Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1010 W 11th St, Panama City, Florida |
| Authorized Official Name and Position | Susan Stewart (MANAGER) |
| Authorized Official Contact | 3346762320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Dental Group Smiles On 11th Llc 3150 Zelda Ct Montgomery AL 36106-2607 Ph: (334) 676-2320 | Genesis Dental Group Smiles On 11th Llc 1010 W 11th St Panama City FL 32401-2042 Ph: (850) 763-3622 |
| NPI Number | 1629598750 |
|---|---|
| Provider Enumeration Date | 06/20/2017 |
| Last Update Date | 06/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629598750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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