DENTAL 192

NPI: 1346689791 · Organization · Active

Primary Specialty

General Practice Dentistry
Dentist — General Practice

Practice Location

100 W NEW HAVEN AVE
MELBOURNE, FL 32901-4303 Map ↗
Phone: 630-659-5293

All Specialties & Licenses

  • General Practice Dentistry Primary — General Practice (license: DN17724, FL)

NPI Registration

Enumerated: 2013-06-19

Last CMS Update: 2013-06-19