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General NPI Number Information
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NPI Number | 1033824313
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Entity Type | Organization
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Legal Business Name | FLORIDA DENTAL TEAM, LLC
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Dates
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Enumeration Date | 01/20/2023
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1620 S CONGRESS AVE STE 101
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City | PALM SPRINGS
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State | FL
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Zip | 33461-2128
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Country | US
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Telephone | 561-291-9839
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Fax | 561-437-0403
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Provider Business Mailing Address
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Address Line | 9709 LAKESIDE BLVD STE 350
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City | SPRING
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State | TX
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Zip | 77381-1213
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Country | US
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Telephone | 713-489-2198
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Fax | 713-489-2978
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Authorized Official
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Title or Position | OWNER
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Name | JUAN OJEDA
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Credential | DMD
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Telephone | 407-797-1543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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