| Vbdc Of Lake Park Pllc | |
|
101 N Congress Ave Lake Park FL 33403-3804 | |
| (478) 733-0857 | |
| (478) 254-5709 |
| Full Name | Vbdc Of Lake Park Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 N Congress Ave, Lake Park, Florida |
| Authorized Official Name and Position | Paul Jason Mann (OWNER) |
| Authorized Official Contact | 4787330857 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vbdc Of Lake Park Pllc 225 N Macon St Macon GA 31210-6562 Ph: (478) 733-0857 | Vbdc Of Lake Park Pllc 101 N Congress Ave Lake Park FL 33403-3804 Ph: (478) 733-0857 |
| NPI Number | 1861964116 |
|---|---|
| Provider Enumeration Date | 12/27/2018 |
| Last Update Date | 12/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861964116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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