| Magnolia Green Dental Care, P.a. | |
|
6975 Professional Pkwy Ste B Lakewood Ranch FL 34240-8430 | |
| (941) 240-2750 | |
| (863) 808-0589 |
| Full Name | Magnolia Green Dental Care, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 6975 Professional Pkwy Ste B, Lakewood Ranch, Florida |
| Authorized Official Name and Position | Kevin Krause (PRESIDENT) |
| Authorized Official Contact | 9419233802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Green Dental Care, P.a. 1 N Dale Mabry Hwy Ste 605 Tampa FL 33609-2781 Ph: (813) 692-2224 | Magnolia Green Dental Care, P.a. 6975 Professional Pkwy Ste B Lakewood Ranch FL 34240-8430 Ph: (941) 240-2750 |
| NPI Number | 1316671688 |
|---|---|
| Provider Enumeration Date | 07/13/2022 |
| Last Update Date | 07/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316671688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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