MEDICARE: SMART CHOICE DENTAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1588491344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMART CHOICE DENTAL LLC

Provider Business Mailing Address
First Line	:	2509 SW 11TH CT
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-4120
Country	:	US
Telephone Number	:	786-803-7345
Fax Number	:

Provider Business Practice Location Address
First Line	:	16520 S TAMIAMI TRL STE 106
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-5319
Country	:	US
Telephone Number	:	786-803-7345
Fax Number	:

Authorized Official
Title or Position	:	GENERAL DENTIST
Name	:	DR. YANDY N/A RODRIGUEZ OROZCO
Credential	:	DMD
Telephone Number	:	786-803-7345

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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Directions to “SMART CHOICE DENTAL LLC ” Practice Location

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