Organization
VITRAL ORTHODONTICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLELENNY SANTANA DMD (PRESIDENT)
(407) 907-6361
Entity
Organization
Contact information
Practice address
114 WILSHIRE BLVD, CASSELBERRY, FL 32707-5345
(407) 907-6361
Mailing address
114 WILSHIRE BLVD, CASSELBERRY, FL 32707-5345
(407) 907-6361
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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