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Organization
SOH OF FLORIDA PA
Active
Organization
SOH OF FLORIDA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLY SUNSHINE (CREDENTIALING SPECIALIST)
(314) 413-2803
Entity
Organization
Contact information
Practice address
610 N MILLS AVE STE 200, ORLANDO, FL 32803-7113
(407) 674-8770
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
(636) 362-4986
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/28/2018
Last updated
04/07/2025
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