Lumina Dental Of Lakeland,pa | |
4912 Southfork Dr Lakeland FL 33813-2042 | |
(863) 455-4348 | |
Not Available |
Full Name | Lumina Dental Of Lakeland,pa |
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Speciality | Clinic/center - Dental |
Location | 4912 Southfork Dr, Lakeland, Florida |
Authorized Official Name and Position | John Ivey (OWNER) |
Authorized Official Contact | 3214312208 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lumina Dental Of Lakeland,pa 4912 Southfork Dr Lakeland FL 33813-2042 Ph: (863) 455-4348 | Lumina Dental Of Lakeland,pa 4912 Southfork Dr Lakeland FL 33813-2042 Ph: (863) 455-4348 |
NPI Number | 1487292454 |
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Provider Enumeration Date | 12/20/2019 |
Last Update Date | 12/20/2019 |
Identifier | Type | State | Issuer |
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1487292454 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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