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Organization
HOUSE OF COSMETIC DENTISTRY
Active
Organization
HOUSE OF COSMETIC DENTISTRY
Active
Other names
Fortune Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINA SEGURA (OFFICE MANAGER)
(407) 348-2002
Entity
Organization
Contact information
Practice address
2324 FORTUNE RD, KISSIMMEE, FL 34744-3993
(407) 348-2002
(407) 348-2009
Mailing address
2324 FORTUNE RD, KISSIMMEE, FL 34744-3993
(407) 348-2002
(407) 348-2009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN16387
FL
1223G0001X
General Practice Dentistry
DN16586
FL
Other
Enumeration date
08/03/2011
Last updated
09/02/2015
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