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General NPI Number Information
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NPI Number | 1265644348
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA SMILES, INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2855 W SR 434 SUITE 1011
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City | LONGWOOD
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State | FL
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Zip | 32779
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Country | US
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Telephone | 407-862-1870
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Fax | 407-682-7004
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Provider Business Mailing Address
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Address Line | 2855 W SR 434 SUITE 1011
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City | LONGWOOD
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State | FL
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Zip | 32779
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Country | US
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Telephone | 407-862-1870
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Fax | 407-682-7004
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. NICHOLAS JOHN SAVASTANO JR.
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Credential | DMD.,MS
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Telephone | 407-862-1870
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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 | 6776
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 15487
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License Number State | FL
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