Healthcare Provider Details

I. General information

NPI: 1487211520
Provider Name (Legal Business Name): AFFORDABLE DENTURES & IMPLANTS - ORLANDO IV, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1163 BLACKWOOD AVE
OCOEE FL
34761-4518
US

IV. Provider business mailing address

1163 BLACKWOOD AVE
OCOEE FL
34761-4518
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-3828
  • Fax:
Mailing address:
  • Phone: 407-877-3828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: RAMZY LOTFI
Title or Position: OWNER
Credential: DMD
Phone: 407-877-3828