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General NPI Number Information
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NPI Number | 1477323798
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Entity Type | Organization
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Legal Business Name | ARIETTA DENTAL PLLC
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1737 6TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-2301
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Country | US
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Telephone | 863-508-2565
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Fax | 863-508-2566
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Provider Business Mailing Address
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Address Line | 526 SHALISA BLVD
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City | AUBURNDALE
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State | FL
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Zip | 33823-9667
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Country | US
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Telephone | 407-721-6825
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | CAROLINA LONDONO
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Credential | DMD
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Telephone | 863-508-2565
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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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