Sage Dental Of Maitland PLLC
Dentist in Altamonte Springs, FL. Organization (NPI-2).
NPI number1710692892
StatusActive
Last updated in NPPESJun 8, 2023
Details
- NPI
- 1710692892
- Entity type
- Organization (NPI-2)
- Legal business name
- Sage Dental Of Maitland PLLC
- Organization subpart
- No
- Enumeration date
- Jan 23, 2023
- Certification date
- Jun 8, 2023
- Last updated
- Jun 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
9439 Forest City Cv Ste 1070Altamonte Springs, FL 32714-1515
Phone 561-999-9650
Mailing address
6600 Congress Ave Ste 150Boca Raton, FL 33487-1213
Phone 561-999-9650
Authorized official
Cindy Roark
Svp & Chief Clinical Officer
5619999650
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