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Organization
PACE-FL DENTAL, PA
Active
Organization
PACE-FL DENTAL, PA
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MIKA L. WEISS (PROVIDER RELATIONS)
(315) 454-6000
Entity
Organization
Contact information
Practice address
4873 HIGHWAY 90 STE A, MILTON, FL 32571-1401
(315) 454-6000
Mailing address
4873 HIGHWAY 90 STE A, MILTON, FL 32571-1401
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16315
FL
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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