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Organization
SOUTHEASTERN DENTAL GROUP
Active
Organization
SOUTHEASTERN DENTAL GROUP
Active
Other names
Family And Cosmetic Dentistry At Vista Lakes
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J MORRA DMD (MANAGING PARTNER)
(407) 382-2282
Entity
Organization
Contact information
Practice address
6415 SOUTH CHICKASAW TRAIL, ORLANDO, FL 32829
(407) 382-2282
(407) 382-2858
Mailing address
6415 SOUTH CHICKASAW TRAIL, ORLANDO, FL 32829
(407) 382-2282
(407) 382-2858
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN15633
FL
122300000X
Dentist
Primary
DN15714
FL
Other
Enumeration date
08/11/2006
Last updated
08/22/2020
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