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General NPI Number Information
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NPI Number | 1467032524
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Entity Type | Organization
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Legal Business Name | METROWEST DENTAL CARE ,CORP
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 1507 S HIAWASSEE RD STE 209
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City | ORLANDO
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State | FL
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Zip | 32835-5719
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Country | US
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Telephone | 407-286-4750
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Fax | 407-286-4732
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Provider Business Mailing Address
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Address Line | 1507 S HIAWASSEE RD STE 209
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City | ORLANDO
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State | FL
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Zip | 32835-5719
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Country | US
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Telephone | 407-286-4750
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Fax | 407-286-4703
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Authorized Official
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Title or Position | OWNER
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Name | DR. LUZ AIDA OSPINA
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Credential | DDS
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Telephone | 208-312-0190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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