| Lake Mary Smiles, Pllc | |
|
570 Rinehart Rd Ste 110 Lake Mary FL 32746-4801 | |
| (407) 333-7393 | |
| Not Available |
| Full Name | Lake Mary Smiles, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 570 Rinehart Rd Ste 110, Lake Mary, Florida |
| Authorized Official Name and Position | Peter Kelly (OWNER) |
| Authorized Official Contact | 4073337393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Mary Smiles, Pllc 3221 Conway Rd Ste D Orlando FL 32812-7354 Ph: (407) 432-6224 | Lake Mary Smiles, Pllc 570 Rinehart Rd Ste 110 Lake Mary FL 32746-4801 Ph: (407) 333-7393 |
| NPI Number | 1588314686 |
|---|---|
| Provider Enumeration Date | 03/24/2022 |
| Last Update Date | 03/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588314686 | NPI | - | NPPES |
| DM19430 | Other | FL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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