| True Vine Dental Care | |
|
2633 W State Road 434 Longwood FL 32779-4878 | |
| (602) 481-0153 | |
| Not Available |
| Full Name | True Vine Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2633 W State Road 434, Longwood, Florida |
| Authorized Official Name and Position | Shady Ashamalla (OWNER/DENTIST) |
| Authorized Official Contact | 6024810153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| True Vine Dental Care 3051 Zaharias Dr Orlando FL 32837-7025 Ph: () - | True Vine Dental Care 2633 W State Road 434 Longwood FL 32779-4878 Ph: (602) 481-0153 |
| NPI Number | 1477302784 |
|---|---|
| Provider Enumeration Date | 05/17/2024 |
| Last Update Date | 05/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477302784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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