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General NPI Number Information
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NPI Number | 1972374486
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Entity Type | Organization
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Legal Business Name | YOUR DOWNTOWN DENTISTRY PLLC
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 611 N MAGNOLIA AVE
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City | ORLANDO
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State | FL
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Zip | 32801-1217
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Country | US
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Telephone | 407-502-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 611 N MAGNOLIA AVE
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City | ORLANDO
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State | FL
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Zip | 32801-1217
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Country | US
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Telephone | 407-502-0202
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | SAHIRA LOPEZ
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Credential |
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Telephone | 407-718-0811
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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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