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General NPI Number Information
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NPI Number | 1790933554
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Entity Type | Organization
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Legal Business Name | SIGMA DENTAL OF KISSIMMEE, LLC
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 2102 E OSCEOLA PKWY SUITES 2102-2104
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City | KISSIMMEE
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State | FL
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Zip | 34743-8630
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Country | US
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Telephone | 407-931-3962
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Fax | 407-932-0800
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Provider Business Mailing Address
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Address Line | 2102 E OSCEOLA PKWY SUITES 2102-2104
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City | KISSIMMEE
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State | FL
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Zip | 34743-8630
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Country | US
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Telephone | 407-201-3998
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Fax | 407-931-3962
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MISS FABIOLA ELENA SOPRANO
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Credential |
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Telephone | 407-451-5866
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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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