Healthcare Provider Details

I. General information

NPI: 1215751813
Provider Name (Legal Business Name): DENTAL ZONE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 WEST RD
OCOEE FL
34761-5300
US

IV. Provider business mailing address

315 WEST RD
OCOEE FL
34761-5300
US

V. Phone/Fax

Practice location:
  • Phone: 407-378-3704
  • Fax: 407-378-2637
Mailing address:
  • Phone: 407-378-3704
  • Fax: 407-378-2637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALIUSKA LOPEZ
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 407-378-3704