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General NPI Number Information
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NPI Number | 1477672301
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Entity Type | Organization
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Legal Business Name | WINDERMERE DENTAL GROUP
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 6996 PIAZZA GRANDE AVE. SUITE 209
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City | ORLANDO
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State | FL
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Zip | 32835
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Country | US
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Telephone | 407-294-1132
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Fax | 407-294-1459
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Provider Business Mailing Address
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Address Line | 6996 PIAZZA GRANDE AVE SUITE 209
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City | ORLANDO
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State | FL
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Zip | 32835
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Country | US
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Telephone | 407-294-1132
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Fax | 407-294-1459
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ALEJANDRO MONCADA
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Credential |
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Telephone | 407-294-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | FL
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