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Organization
AZGAN DENTAL MANAGEMENT COMPANY PLLC
Active
Organization
AZGAN DENTAL MANAGEMENT COMPANY PLLC
Active
Other names
Lucie Dental Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
SUZEL GONZALEZ (BILLING DIRECTOR)
(772) 812-4903
Entity
Organization
Contact information
Practice address
1465 NW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1968
(772) 348-4403
Mailing address
1465 NW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1968
(772) 348-4403
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
09/30/2022
Last updated
09/30/2022
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