Organization
L & L PORT ORANGE, LLC
Active
Other names
Kevin Marvin
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE JOSEPH LECOMPTE JR. DDS, MS (OWNER/MANAGER)
(386) 295-3815
Entity
Organization
Contact information
Practice address
4904 S CLYDE MORRIS BLVD, SUITE B, PORT ORANGE, FL 32129
(386) 788-9959
(386) 788-9850
Mailing address
3890 TURTLE CREEK DRIVE, SUITE A, PORT ORANGE, FL 32127
(386) 761-5440
(386) 760-0474
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
DN12922
FL
261QD0000X
Dental Clinic/Center
Primary
DN7283
FL
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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