Organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Active
Parent organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Authorized official
BRIAN SMITH (CFO)
(770) 231-5348
Entity
Organization
Contact information
Practice address
737 3RD ST SW, WINTER HAVEN, FL 33880-3419
(863) 644-4739
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(470) 207-3264
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
04/28/2021
Last updated
01/21/2025
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