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Organization
SENIOR DENTAL CARE
Active
Organization
SENIOR DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CASSI LAYNE (PRESIDENT)
(850) 398-4425
Entity
Organization
Contact information
Practice address
16700 SE PEAR ST, BLOUNTSTOWN, FL 32424-2177
(850) 398-4425
Mailing address
PO BOX 367, BLOUNTSTOWN, FL 32424-0367
(850) 398-4425
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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