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General NPI Number Information
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NPI Number | 1902158710
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Entity Type | Individual
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Provider Name | MARIA A. KASHLAK D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 6068 S. APOPLA VINELAND RD. SUITE 6
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-345-5620
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Fax | 407-345-8063
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Provider Business Mailing Address
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Address Line | 6068 S. APOPLA VINELAND RD. SUITE 6
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-345-5620
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Fax | 407-345-8063
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN-0011469
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License Number State | FL
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