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General NPI Number Information
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NPI Number | 1649510975
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Entity Type | Organization
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Legal Business Name | FAMILY DENTISTRY & DENTAL SPECIALISTS GROUP
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Dates
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Enumeration Date | 02/23/2013
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Last Update Date | 02/23/2013
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Provider Practice Location Address
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Address Line | 4250 TOWN CENTER BLVD
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City | ORLANDO
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State | FL
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Zip | 32837-6192
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Country | US
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Telephone | 407-856-0208
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Fax |
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Provider Business Mailing Address
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Address Line | 9336 SOUTHERN BREEZE DR
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City | ORLANDO
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State | FL
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Zip | 32836-5056
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Country | US
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Telephone | 407-421-6888
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANMOHAN BATTA
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Credential | BDS,MDS,MS
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Telephone | 407-421-6888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | P96000000303
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License Number State | FL
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