Victus Dental Ii Pa | |
1308 West 9 Mile Rd Suite 9 Penscola FL 32534-3253 | |
(850) 484-4844 | |
Not Available |
Full Name | Victus Dental Ii Pa |
---|---|
Speciality | Clinic/center - Dental |
Location | 1308 West 9 Mile Rd Suite 9, Penscola, Florida |
Authorized Official Name and Position | Anthony Le (PRESIDENT) |
Authorized Official Contact | 2013753363 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Victus Dental Ii Pa 2850 Monroe St Ste B Pensacola FL 32514-7656 Ph: () - | Victus Dental Ii Pa 1308 West 9 Mile Rd Suite 9 Penscola FL 32534-3253 Ph: (850) 484-4844 |
NPI Number | 1467917823 |
---|---|
Provider Enumeration Date | 02/09/2019 |
Last Update Date | 09/06/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467917823 | NPI | - | NPPES |
025098900 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |