Organization
ALTAMONTE MALL DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSTISLAV KRASNOV DDS (OWNER)
(954) 846-7171
Entity
Organization
Contact information
Practice address
451 E ALTAMONTE DR STE 1279, ALTAMONTE SPRINGS, FL 32701-4617
(954) 846-7171
(954) 846-7170
Mailing address
451 E ALTAMONTE DR STE 1279, ALTAMONTE SPRINGS, FL 32701-4617
(954) 846-7171
(954) 846-7170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN16377
FL
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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