LAKE BUTLER DENTAL GROUP PA NPI 1124732698

NPI Information

NPI: 1124732698
Provider Name: LAKE BUTLER DENTAL GROUP PA
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4014 WINTER GARDEN VINELAND ROAD
SUITE B
WINTER GARDEN, FL
ZIP 34787
Phone: (321) 248-2923
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LAKE BUTLER DENTAL GROUP PA is a dental clinic center in Winter Garden, FL. LAKE BUTLER DENTAL GROUP PA NPI is 1124732698. The provider is registered as an organization entity type.

The provider's business location address is:

4014 WINTER GARDEN VINELAND ROAD
SUITE B
WINTER GARDEN, FL
ZIP 34787
Phone: (321) 248-2923
Fax: (321) 418-8920

The provider's authorized official is Minh Pham .
The authorized official title is Owner and has the following contact phone number (321) 248-2923.

The enumeration date for this NPI number is 1/10/2023 and was last updated on 1/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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