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General NPI Number Information
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NPI Number | 1568107449
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Entity Type | Organization
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Legal Business Name | A'S DENTAL SERVICES, LLC
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 8511 S US HIGHWAY 1
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-3346
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Country | US
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Telephone | 772-878-5880
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Fax | 772-878-7475
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Provider Business Mailing Address
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Address Line | 8511 S US HIGHWAY 1
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-3346
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Country | US
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Telephone | 772-878-5880
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Fax | 772-878-7475
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | NERISSA AQUINO
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Credential | DDS
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Telephone | 772-878-5880
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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 |
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