Organization
LAKELAND MODERN DENTISTRY, PA
Active
Other names
Lakeland Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY MABRY DDS (OWNER DOCTOR)
(863) 216-5765
Entity
Organization
Contact information
Practice address
4620 S FLORIDA AVE STE 120, LAKELAND, FL 33813-2166
(863) 216-5765
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/02/2017
Last updated
06/15/2022
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