| Southpark Dental Group | |
|
8801 Commodity Cir Orlando FL 32819-9053 | |
| (407) 248-0100 | |
| (407) 248-8364 |
| Full Name | Southpark Dental Group |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 8801 Commodity Cir, Orlando, Florida |
| Authorized Official Name and Position | John F Cervenka (OWNER) |
| Authorized Official Contact | 4072480100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southpark Dental Group 8801 Commodity Cir Orlando FL 32819-9053 Ph: (407) 248-0100 | Southpark Dental Group 8801 Commodity Cir Orlando FL 32819-9053 Ph: (407) 248-0100 |
| NPI Number | 1093815029 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093815029 | NPI | - | NPPES |
| 836729 | Other | UNITED CONCORDIA |
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