| St. Cloud Smiles, Inc. | |
|
2050 Old Hickory Tree Rd Suite J Saint Cloud FL 34772-8926 | |
| (407) 556-3969 | |
| Not Available |
| Full Name | St. Cloud Smiles, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2050 Old Hickory Tree Rd, Saint Cloud, Florida |
| Authorized Official Name and Position | Jennifer Trang Van (OWNER) |
| Authorized Official Contact | 9544838184 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Cloud Smiles, Inc. 2050 Old Hickory Tree Rd Suite J Saint Cloud FL 34772-8926 Ph: (407) 556-3969 | St. Cloud Smiles, Inc. 2050 Old Hickory Tree Rd Suite J Saint Cloud FL 34772-8926 Ph: (407) 556-3969 |
| NPI Number | 1023338597 |
|---|---|
| Provider Enumeration Date | 06/08/2010 |
| Last Update Date | 06/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023338597 | NPI | - | NPPES |
| 000333100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN18003 (Florida) | Primary |
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