Organization
DENTIST OF LAKE MARY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DHARAM PAL TAYAL DDS (MEMBER)
(716) 239-5889
Entity
Organization
Contact information
Practice address
229 WHEELHOUSE LN STE 1241, LAKE MARY, FL 32746-3665
(407) 284-1645
Mailing address
12250 STRATEGY BLVD STE 437, ORLANDO, FL 32817-2108
(407) 284-1645
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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