Lumina Dentalof Brandon, PA
Clinic/Center, Dental in Brandon, FL. Organization (NPI-2).
NPI number1982242111
StatusActive
Last updated in NPPESDec 18, 2019
Details
- NPI
- 1982242111
- Entity type
- Organization (NPI-2)
- Legal business name
- Lumina Dentalof Brandon, PA
- Organization subpart
- No
- Enumeration date
- Dec 18, 2019
- Certification date
- Dec 18, 2019
- Last updated
- Dec 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Lumina Dental Of Brandon (Doing Business As)
Practice location
225 Brandon Town Center DrBrandon, FL 33511-4728
Phone 813-381-5858
Mailing address
225 Brandon Town Center DrBrandon, FL 33511-4728
Phone 813-381-5858
Authorized official
Sylvia Miller
Insurance Coordinator
3214312208
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