Organization
NEW ROOTS DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YESELL CANDELARIO-BENITEZ DDS (OWNER)
(786) 307-8655
Entity
Organization
Contact information
Practice address
198 S NOVA RD, ORMOND BEACH, FL 32174-6115
(786) 307-8655
Mailing address
198 S NOVA RD, ORMOND BEACH, FL 32174-6115
(786) 307-8655
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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