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Organization
TRADITION DENTAL, P.A.
Active
Organization
TRADITION DENTAL, P.A.
Active
Other names
Tradition Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MINA HARROUFF (SECRETARY)
(561) 401-5006
Entity
Organization
Contact information
Practice address
1973 SW SAVAGE BLVD STE 205, PORT ST LUCIE, FL 34953-2791
(772) 207-1213
(772) 877-2862
Mailing address
1973 SW SAVAGE BLVD STE 205, PORT ST LUCIE, FL 34953-2791
(772) 207-1213
(772) 877-2862
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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