| Palm Coast Dental, Llc | |
|
5234 E. Highway 100 Suite 103 Palm Coast FL 32164 | |
| (386) 263-2936 | |
| Not Available |
| Full Name | Palm Coast Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 5234 E. Highway 100, Palm Coast, Florida |
| Authorized Official Name and Position | Thai Thanh Nong (DENTIST/OWNER) |
| Authorized Official Contact | 3862375917 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palm Coast Dental, Llc 5234 E. Highway 100 Suite 103 Palm Coast FL 32164 Ph: (386) 263-2936 | Palm Coast Dental, Llc 5234 E. Highway 100 Suite 103 Palm Coast FL 32164 Ph: (386) 263-2936 |
| NPI Number | 1356585566 |
|---|---|
| Provider Enumeration Date | 05/01/2009 |
| Last Update Date | 05/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356585566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN17327 (Florida) | Primary |
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