| Osceola Dental, Inc | |
|
3066 Michigan Ave Kissimmee FL 34744-1544 | |
| (407) 343-9800 | |
| (407) 343-9802 |
| Full Name | Osceola Dental, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3066 Michigan Ave, Kissimmee, Florida |
| Authorized Official Name and Position | Anaura Tirado Velazquez (PRESIDENT) |
| Authorized Official Contact | 4073439800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Osceola Dental, Inc 3066 Michigan Ave Kissimmee FL 34744-1544 Ph: (407) 343-9800 | Osceola Dental, Inc 3066 Michigan Ave Kissimmee FL 34744-1544 Ph: (407) 343-9800 |
| NPI Number | 1356547418 |
|---|---|
| Provider Enumeration Date | 06/25/2007 |
| Last Update Date | 09/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356547418 | NPI | - | NPPES |
| 074075600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN12467 (Florida) | Primary |
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