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General NPI Number Information
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NPI Number | 1124992599
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Entity Type | Organization
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Legal Business Name | WEST COAST DENTAL PARTNERS
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 751 HARLEY STRICKLAND BLVD
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City | ORANGE CITY
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State | FL
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Zip | 32763-7947
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Country | US
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Telephone | 386-406-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 751 HARLEY STRICKLAND BLVD
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City | ORANGE CITY
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State | FL
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Zip | 32763-7947
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Country | US
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Telephone | 386-406-9993
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | TINA CANALEJO HILLER
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Credential |
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Telephone | 813-389-4724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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