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General NPI Number Information
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NPI Number | 1013476084
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Entity Type | Organization
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Legal Business Name | BELLASMILES ORTHODONTICS PA
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 12001 AVALON LAKE DR STE K
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City | ORLANDO
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State | FL
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Zip | 32828-7399
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Country | US
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Telephone | 407-680-3197
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Fax |
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Provider Business Mailing Address
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Address Line | 358 FAIRWAY POINTE CIR
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City | ORLANDO
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State | FL
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Zip | 32828-8515
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Country | US
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Telephone | 407-680-3197
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NAILA ORTEGA
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Credential | DDS
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Telephone | 305-389-5734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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