Organization
MCDONNELL DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENIFER HARTMANN (OFFICE ADMINISTRATOR)
(386) 410-4943
Entity
Organization
Contact information
Practice address
1440 REED CANAL RD STE 101, PORT ORANGE, FL 32129-9460
(386) 410-4943
(386) 339-0321
Mailing address
1440 REED CANAL RD STE 101, PORT ORANGE, FL 32129-9460
(386) 410-4943
(386) 339-0321
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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