MEDICARE: WINTER SPRINGS FAMILY DENTAL, P.A.

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	DN20254	FL

General Provider Information

NPI Number	:	1760986509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINTER SPRINGS FAMILY DENTAL, P.A.

Provider Business Mailing Address
First Line	:	4755 HIGHWAY A1A
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-5402
Country	:	US
Telephone Number	:	772-231-6004
Fax Number	:	772-231-7249

Provider Business Practice Location Address
First Line	:	5220 RED BUG LAKE RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4912
Country	:	US
Telephone Number	:	772-231-6004
Fax Number	:	772-231-7249

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALEX A PLANES
Credential	:	DMD
Telephone Number	:	305-613-2615

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	12/09/2020

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