Kissimmee Family Dentistry, PLLC
Dentist, General Practice in Kissimmee, FL. Organization (NPI-2).
NPI number1407257561
StatusActive
Last updated in NPPESDec 4, 2019
Details
- NPI
- 1407257561
- Entity type
- Organization (NPI-2)
- Legal business name
- Kissimmee Family Dentistry, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 9, 2014
- Last updated
- Dec 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DN 18060 | FL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Practice location
1111 Person StKissimmee, FL 34741-4146
Phone 407-870-7404 · Fax 407-870-9960
Mailing address
1111 Person StKissimmee, FL 34741-4146
Phone 407-870-7404 · Fax 407-870-9960
Authorized official
Patrick J Mokris
Owner
4078707404
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