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Organization
LAKE MYRTLE CENTER FOR ADVANCED DENTISTRY
Active
Organization
LAKE MYRTLE CENTER FOR ADVANCED DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY ACOSTA D.M.D, (DENTIST)
(863) 662-9973
Entity
Organization
Contact information
Practice address
2016 US HIGHWAY 92 W, AUBURNDALE, FL 33823-3921
(863) 662-9973
(863) 875-5736
Mailing address
2016 US HIGHWAY 92 W, AUBURNDALE, FL 33823-3921
(863) 662-9973
(863) 875-5736
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16643
FL
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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