# UNIVERSAL SMILES DENTISTRY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578999462
- **Authorized official:** DR. SURENDRA G SIRIVOLU DDS (PRACTICE MANAGER)
- **Authorized official phone:** (321) 278-3933

## Contact information

- **Practice address:** 6735 CONROY WINDERMERE RD, SUITE\# 202, ORLANDO, FL 32835-3565
- **Practice address phone:** (407) 910-1178
- **Mailing address:** 6735 CONROY WINDERMERE RD, SUITE\# 202, ORLANDO, FL 32835-3565
- **Mailing address phone:** (407) 910-1178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DN17057 | FL | Yes |
| 261QD0000X | Dental Clinic/Center | DN17923 | FL | — |

## Other

- **Enumeration date:** 09/24/2013
- **Last updated:** 09/24/2013