| Happy Smiles Of Port Saint Lucie | |
|
1100 Sw St Lucie Blvd 206 Port Saint Lucie FL 34986-1780 | |
| (772) 807-1451 | |
| Not Available |
| Full Name | Happy Smiles Of Port Saint Lucie |
|---|---|
| Speciality | Dentist |
| Location | 1100 Sw St Lucie Blvd, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Simon Leizgold (OPERATIONS MANAGER) |
| Authorized Official Contact | 7728071451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Happy Smiles Of Port Saint Lucie 1100 Sw Saint Lucie Blvd 206 Port Saint Lucie FL 34986 Ph: (772) 807-1451 | Happy Smiles Of Port Saint Lucie 1100 Sw St Lucie Blvd 206 Port Saint Lucie FL 34986-1780 Ph: (772) 807-1451 |
| NPI Number | 1962862805 |
|---|---|
| Provider Enumeration Date | 03/04/2016 |
| Last Update Date | 03/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962862805 | NPI | - | NPPES |
| 000800101 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN16481 (Florida) | Primary |
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