Organization
CENTER FOR INTEGRATIVE ORAL HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAISRI R THOPPAY DDS (PRESIDENT)
(407) 664-6999
Entity
Organization
Contact information
Practice address
7151 UNIVERSITY BLVD UNIT 110, WINTER PARK, FL 32792-6724
(407) 664-6999
Mailing address
7151 UNIVERSITY BLVD UNIT 110, WINTER PARK, FL 32792-6724
(407) 664-6999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
125Q00000X
Oral Medicine Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LY180
MEDICARE PTAN
FL
Enumeration date
08/20/2019
Last updated
01/17/2020
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