| |
272 Sw Bentley Pl Lake City FL 32025-6972 | |
(386) 752-3043 | |
(386) 755-1466 |
Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 272 Sw Bentley Pl, Lake City, Florida |
Authorized Official Name and Position | Johann Ramkissoon (MANAGER) |
Authorized Official Contact | 3867523043 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
272 Sw Bentley Pl Lake City FL 32025-6972 Ph: (386) 752-3043 | 272 Sw Bentley Pl Lake City FL 32025-6972 Ph: (386) 752-3043 |
NPI Number | 1013657063 |
---|---|
Provider Enumeration Date | 03/29/2022 |
Last Update Date | 05/03/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013657063 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
Gregory N Borganelli Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 875 Sw State Rd 47, Lake City, FL 32025 Phone: 386-752-8200 Fax: 386-752-8209 | |
Melanie Holden, Dmd, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 Sw Main Blvd, Lake City, FL 32025 Phone: 386-752-2480 | |
David F Randolph Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1779 Sw Barnett Way Ste 101, Lake City, FL 32025 Phone: 386-755-4033 Fax: 386-755-2581 |