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General NPI Number Information
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NPI Number | 1851503577
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Entity Type | Organization
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Legal Business Name | COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 2127 W STATE ROAD 434
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City | LONGWOOD
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State | FL
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Zip | 32779-4983
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Country | US
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Telephone | 407-332-6060
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Fax | 407-332-8190
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Provider Business Mailing Address
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Address Line | 2127 W STATE ROAD 434
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City | LONGWOOD
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State | FL
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Zip | 32779-4983
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Country | US
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Telephone | 407-332-6060
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Fax | 407-332-8190
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Authorized Official
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Title or Position | INS COOD
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Name | ALL CREDENTIALING
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Credential |
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Telephone | 217-540-2100
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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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