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Organization
AEGEAN DENTAL OF PORT ST LUCIE, LLC
Active
Organization
AEGEAN DENTAL OF PORT ST LUCIE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE SOROPOULOS DDS, BSME (MANAGER)
(561) 395-1486
Entity
Organization
Contact information
Practice address
308 NW BETHANY DR, PORT ST LUCIE, FL 34986-3578
(772) 344-4356
Mailing address
2151 NW 2ND AVE, 101, BOCA RATON, FL 33431-6771
(561) 395-1486
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15874
FL
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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