Organization
LAKE BUENA VISTA DENTAL P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (INSURANCE DIRECTOR)
(727) 726-1611
Entity
Organization
Contact information
Practice address
12131 S. APOPKA-VINELAND ROAD, ORLANDO, FL 32801
(407) 239-8883
Mailing address
12131 S. APOPKA-VINELAND ROAD, ORLANDO, FL 32801
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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