Organization
DR GUSTAVO DE OLIVEIRA DMD, P.A.
Active
Other names
Lake Lucerne Lifestyle Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUSTAVO DE OLIVEIRA DMD (OWNER)
(407) 425-4901
Entity
Organization
Contact information
Practice address
112 E LUCERNE CIR, ORLANDO, FL 32801-4401
(407) 425-4901
Mailing address
1407 BELMONT DR, ORLANDO, FL 32806-2402
(407) 627-9111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
03/31/2021
Last updated
04/27/2021
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