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Organization
DELAND DENTAL
Active
Organization
DELAND DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS MEDINA (DENTIST)
(386) 736-7309
Entity
Organization
Contact information
Practice address
240 E NEW YORK AVE, DELAND, FL 32724-5522
(386) 736-7309
(386) 736-7205
Mailing address
240 E NEW YORK AVE, DELAND, FL 32724-5522
(386) 736-7309
(386) 736-7205
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN15845
FL
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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