| Ideal Dental Of Lee Vista | |
|
6784 Eagle Watch Dr Ste 550 Orlando FL 32822-2355 | |
| (407) 982-7996 | |
| Not Available |
| Full Name | Ideal Dental Of Lee Vista |
|---|---|
| Speciality | Dentist |
| Location | 6784 Eagle Watch Dr Ste 550, Orlando, Florida |
| Authorized Official Name and Position | Joshua Coussa (OWNER) |
| Authorized Official Contact | 4079827996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Dental Of Lee Vista Po Box 840925 Dallas TX 75284-0925 Ph: (972) 361-0600 | Ideal Dental Of Lee Vista 6784 Eagle Watch Dr Ste 550 Orlando FL 32822-2355 Ph: (407) 982-7996 |
| NPI Number | 1083203632 |
|---|---|
| Provider Enumeration Date | 01/18/2021 |
| Last Update Date | 03/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083203632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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