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General NPI Number Information
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NPI Number | 1396427621
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Entity Type | Organization
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Legal Business Name | PRESTIGE SURGICAL ARTS & IMPLANTS CENTER
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 320 N MAITLAND AVE STE A
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City | MAITLAND
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State | FL
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Zip | 32751-4772
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Country | US
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Telephone | 407-794-0335
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Fax | 407-794-0136
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Provider Business Mailing Address
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Address Line | 7703 SADLER RD
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City | MOUNT DORA
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State | FL
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Zip | 32757-7230
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Country | US
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Telephone | 407-754-7652
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Fax |
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. ROBERT DONALD PIERRE II
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Credential | DMD
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Telephone | 407-794-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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