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Organization
UNIVERSAL SMILES DENTISTRY PA
Active
Organization
UNIVERSAL SMILES DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURENDRA G SIRIVOLU DDS (PRACTICE MANAGER)
(321) 278-3933
Entity
Organization
Contact information
Practice address
6735 CONROY WINDERMERE RD, SUITE# 202, ORLANDO, FL 32835-3565
(407) 910-1178
Mailing address
6735 CONROY WINDERMERE RD, SUITE# 202, ORLANDO, FL 32835-3565
(407) 910-1178
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN17057
FL
261QD0000X
Dental Clinic/Center
DN17923
FL
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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