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Organization
PALM COAST DENTAL, LLC
Active
Organization
PALM COAST DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THAI THANH NONG DMD (DENTIST/OWNER)
(386) 237-5917
Entity
Organization
Contact information
Practice address
5234 E. HIGHWAY 100, SUITE 103, PALM COAST, FL 32164
(386) 263-2936
Mailing address
5234 E. HIGHWAY 100, SUITE 103, PALM COAST, FL 32164
(386) 263-2936
(386) 263-2941
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN17327
FL
Other
Enumeration date
05/01/2009
Last updated
05/01/2009
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