VICTUS DENTAL II PA NPI 1467917823

NPI Information

NPI: 1467917823
Provider Name: VICTUS DENTAL II PA
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1308 WEST 9 MILE RD SUITE 9
PENSCOLA, FL
ZIP 32534
Phone: (850) 484-4844
Get Directions

VICTUS DENTAL II PA is a dental clinic center in Penscola, FL. VICTUS DENTAL II PA NPI is 1467917823. The provider is registered as an organization entity type.

The provider's business location address is:

1308 WEST 9 MILE RD SUITE 9
PENSCOLA, FL
ZIP 32534-253
Phone: (850) 484-4844

The provider's authorized official is Anthony Le .
The authorized official title is President and has the following contact phone number (201) 375-3363.

The enumeration date for this NPI number is 2/9/2019 and was last updated on 8/9/2019.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	025098900	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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