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General NPI Number Information
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NPI Number | 1336972595
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Entity Type | Organization
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Legal Business Name | GESSNER DENTAL PA
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Dates
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Enumeration Date | 08/22/2024
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 2855 W STATE ROAD 434 STE 1031
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City | LONGWOOD
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State | FL
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Zip | 32779-4480
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Country | US
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Telephone | 407-862-2299
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Fax |
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Provider Business Mailing Address
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Address Line | 1944 LOBELIA DR
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City | LAKE MARY
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State | FL
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Zip | 32746-2671
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Country | US
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Telephone | 330-402-1625
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. TROY ALBERT GESSNER
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Credential | DDS
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Telephone | 330-402-1625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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