Organization
DENTAL ELEMENTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARA RANDALL (TREATMENT COORDINATOR)
(407) 847-8000
Entity
Organization
Contact information
Practice address
701 E OAK ST STE B, KISSIMMEE, FL 34744-4575
(407) 847-8000
(407) 847-6773
Mailing address
701 E OAK ST STE B, KISSIMMEE, FL 34744-4575
(407) 847-8000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20281
FL
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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