| Space Coast Dentistry | |
|
1490 Cheney Hwy Titusville FL 32780-6250 | |
| (321) 267-3304 | |
| (321) 267-9191 |
| Full Name | Space Coast Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1490 Cheney Hwy, Titusville, Florida |
| Authorized Official Name and Position | Glenna Morris (ADMINISTRATOR OFFICER) |
| Authorized Official Contact | 3212680108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Space Coast Dentistry 1490 Cheney Hwy Titusville FL 32780-6250 Ph: (321) 267-3304 | Space Coast Dentistry 1490 Cheney Hwy Titusville FL 32780-6250 Ph: (321) 267-3304 |
| NPI Number | 1194199364 |
|---|---|
| Provider Enumeration Date | 11/25/2015 |
| Last Update Date | 02/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194199364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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