Your Dentist Inc | |
310 Bellewood Ave South Daytona FL 32119 | |
(386) 760-5511 | |
(386) 760-7848 |
Full Name | Your Dentist Inc |
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Speciality | Dentist |
Location | 310 Bellewood Ave, South Daytona, Florida |
Authorized Official Name and Position | Michael T Maccaro (OWNER PRESIDENT OF CORP DENTIST) |
Authorized Official Contact | 3867605511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Your Dentist Inc 310 Bellewood Ave South Daytona FL 32119 Ph: (386) 760-5511 | Your Dentist Inc 310 Bellewood Ave South Daytona FL 32119 Ph: (386) 760-5511 |
NPI Number | 1023189693 |
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Provider Enumeration Date | 11/13/2006 |
Last Update Date | 08/13/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023189693 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 6899 (Florida) | Primary |
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