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918 E Dixie Ave Leesburg FL 34748-7647 | |
| (321) 231-9410 | |
| (407) 905-6786 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 918 E Dixie Ave, Leesburg, Florida |
| Authorized Official Name and Position | Shireen Dhanani (DENTIST/OWNER) |
| Authorized Official Contact | 3212319410 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
918 E Dixie Ave Leesburg FL 34748-7647 Ph: (321) 231-9410 | 918 E Dixie Ave Leesburg FL 34748-7647 Ph: (321) 231-9410 |
| NPI Number | 1154879732 |
|---|---|
| Provider Enumeration Date | 09/13/2016 |
| Last Update Date | 09/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154879732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Florida) | Primary |
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