| Lifetime Dentistry Of Port Orange | |
|
5445 S. Williamson Blvd Port Orange FL 32128 | |
| (386) 267-6202 | |
| Not Available |
| Full Name | Lifetime Dentistry Of Port Orange |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5445 S. Williamson Blvd, Port Orange, Florida |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Dentistry Of Port Orange 5445 S. Williamson Blvd Port Orange FL 32128 Ph: () - | Lifetime Dentistry Of Port Orange 5445 S. Williamson Blvd Port Orange FL 32128 Ph: (386) 267-6202 |
| NPI Number | 1376915132 |
|---|---|
| Provider Enumeration Date | 10/20/2015 |
| Last Update Date | 10/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376915132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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