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Organization
MID FLORIDA DENTAL
Active
Organization
MID FLORIDA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJESH SHARMA D.D.S (DENTIST)
(407) 870-8047
Entity
Organization
Contact information
Practice address
809 E OAK ST, SUITE 101, KISSIMMEE, FL 34744-5834
(407) 870-5004
Mailing address
809 E OAK ST, SUITE 101, KISSIMMEE, FL 34744-5834
(407) 870-5004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10632
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077825700
—
FL
01
—
11576
MCNA
FL
01
—
193694
DENTAQUEST
FL
Enumeration date
11/29/2010
Last updated
11/29/2010
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