| Smiles Kingdom Inc | |
|
3751 Clyde Morris Blvd Unit 7 Port Orange FL 32129-2356 | |
| (386) 310-3060 | |
| (386) 872-5021 |
| Full Name | Smiles Kingdom Inc |
|---|---|
| Speciality | Dentist |
| Location | 3751 Clyde Morris Blvd, Port Orange, Florida |
| Authorized Official Name and Position | Steve D Taborda (DENTIST) |
| Authorized Official Contact | 3862995625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles Kingdom Inc 3751 Clyde Morris Blvd Unit 7 Port Orange FL 32129-2356 Ph: (386) 310-3060 | Smiles Kingdom Inc 3751 Clyde Morris Blvd Unit 7 Port Orange FL 32129-2356 Ph: (386) 310-3060 |
| NPI Number | 1407215965 |
|---|---|
| Provider Enumeration Date | 02/12/2016 |
| Last Update Date | 02/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407215965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN19830 (Florida) | Primary |
| 122300000X | Dentist | DN21034 (Florida) | Secondary |
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