Healthcare Provider Details
I. General information
NPI: 1780595538
Provider Name (Legal Business Name): SORELLA DENTAL COLLECTIVE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2075 S KANNER HWY
STUART FL
34994-4609
US
IV. Provider business mailing address
725 SW WISPER BAY DR
PALM CITY FL
34990-1429
US
V. Phone/Fax
- Phone: 772-288-9901
- Fax:
- Phone: 321-794-2030
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JENNIFER
PERNA
Title or Position: OWNER
Credential: DMD
Phone: 321-794-2030