| The Dentist | |
|
12344 Roper Blvd Clermont FL 34771-4300 | |
| (352) 242-1763 | |
| (352) 242-6376 |
| Full Name | The Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12344 Roper Blvd, Clermont, Florida |
| Authorized Official Name and Position | James P Costello (PRESIDENT) |
| Authorized Official Contact | 3524081400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dentist 12344 Roper Blvd Clermont FL 34771-4300 Ph: (352) 242-1763 | The Dentist 12344 Roper Blvd Clermont FL 34771-4300 Ph: (352) 242-1763 |
| NPI Number | 1568666576 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568666576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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