Lady Lake Smiles Dentistry, PA
Dentist, General Practice in Lady Lake, FL. Organization (NPI-2).
NPI number1982052262
StatusActive
Last updated in NPPESMay 27, 2016
Details
- NPI
- 1982052262
- Entity type
- Organization (NPI-2)
- Legal business name
- Lady Lake Smiles Dentistry, PA
- Organization subpart
- No
- Enumeration date
- May 27, 2016
- Last updated
- May 27, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Lady Lake Smiles Dentistry (Doing Business As)
Practice location
870 N Us Highway 27A
Lady Lake, FL 32159-3107
Phone 352-282-4785 · Fax 352-432-0752
Mailing address
17000 Red Hill AveIrvine, CA 92614-5626
Phone 714-845-8890 · Fax 949-474-1495
Authorized official
Katie L McCann
Owner Dentist
3522824785
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All 27 General Practice Dentistry providers in Lady Lake · All 651 providers in Lady Lake
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