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General NPI Number Information
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NPI Number | 1336684265
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Entity Type | Organization
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Legal Business Name | DENTAL EXTRACTION CENTER INC
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 540 SOUTH CHICKASAW TRAIL
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City | ORLANDO
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State | FL
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Zip | 32825
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Country | US
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Telephone | 407-250-4832
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Fax |
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Provider Business Mailing Address
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Address Line | 540 SOUTH CHICKASAW TRAIL
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City | ORLANDO
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State | FL
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Zip | 32825
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Country | US
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Telephone | 407-250-4832
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL SZOTT
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Credential |
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Telephone | 407-250-4832
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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 | DN19106
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License Number State | FL
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