Healthcare Provider Details
I. General information
NPI: 1962377507
Provider Name (Legal Business Name): SAPPHIRE DENTAL STUDIO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950 WINDERMERE RD UNIT 12A
WINTER GARDEN FL
34787-6161
US
IV. Provider business mailing address
7148 DESERT MANDARIN ST
WINTER GARDEN FL
34787-3243
US
V. Phone/Fax
- Phone: 407-906-7555
- Fax:
- Phone: 407-906-7555
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CURTIS
DUGAS
Title or Position: OWNER
Credential: DMD
Phone: 407-906-7555