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General NPI Number Information
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NPI Number | 1760323398
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Entity Type | Organization
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Legal Business Name | AMAZING SMILES DENTAL CENTERS LLC
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 857 SW MAIN BLVD STE 105
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City | LAKE CITY
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State | FL
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Zip | 32025-5796
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Country | US
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Telephone | 386-755-7010
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Fax |
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Provider Business Mailing Address
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Address Line | 6960 BONNEVAL RD STE 102
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4045
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | MRS. YEVAH CUETO
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Credential | DDS
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Telephone | 904-616-8253
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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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