Organization
SOUTH ORLANDO DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRALYS M CHARDON DDS (DENTIST)
(407) 857-9888
Entity
Organization
Contact information
Practice address
11222 S ORANGE BLOSSOM TRL, ORLANDO, FL 32837-9428
(407) 857-9888
Mailing address
8309 PRESTBURY DR, ORLANDO, FL 32832-6318
(321) 422-9993
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN18752
FL
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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