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General NPI Number Information
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NPI Number | 1215364427
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Entity Type | Organization
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Legal Business Name | COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PC
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 13816 NARCOOSSEE ROAD SUITE A
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City | ORLANDO
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State | FL
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Zip | 32832-6960
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Country | US
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Telephone | 407-674-0964
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Fax |
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Provider Business Mailing Address
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Address Line | 13816 NARCOOSSEE ROAD SUITE A
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City | ORLANDO
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State | FL
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Zip | 32832-6960
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Country | US
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Telephone | 407-674-0964
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Fax |
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Authorized Official
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Title or Position | INSURANCE/CREDENTIALING
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Name | ALLISON VARNER
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Credential |
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Telephone | 217-540-6077
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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 | DN20330
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License Number State | FL
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