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Organization
SPECIALTY SCANNING LLC
Active
Organization
SPECIALTY SCANNING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONIDES SANDOVAL DDS (MANAGER)
(407) 654-8211
Entity
Organization
Contact information
Practice address
13640 W COLONIAL DR, SUITE 190, WINTER GARDEN, FL 34787-3992
(407) 654-8211
(407) 654-6806
Mailing address
13640 W COLONIAL DR, SUITE 190, WINTER GARDEN, FL 34787-3992
(407) 654-8211
(407) 654-6806
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN13000
FL
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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