| Titusville Dental Clinic | |
|
611 N Singleton Ave Titusville FL 32796-2310 | |
| (321) 241-6800 | |
| (321) 241-6890 |
| Full Name | Titusville Dental Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 611 N Singleton Ave, Titusville, Florida |
| Authorized Official Name and Position | Angela Craig (DIRECTOR OF BILLING) |
| Authorized Official Contact | 3216983446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Titusville Dental Clinic Po Box 1137 Melbourne FL 32902-1137 Ph: (321) 952-9696 | Titusville Dental Clinic 611 N Singleton Ave Titusville FL 32796-2310 Ph: (321) 241-6800 |
| NPI Number | 1740056712 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 12/14/2023 |
| Medicare PECOS PAC ID | 0446201768 |
|---|---|
| Medicare Enrollment ID | O20240130001425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740056712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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