Organization
ORTHODONTICS OF
Active
Organization
ORTHODONTICS OF
Active
Other names
central florida
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARITZA DEJESUS DMD (PRESIDENT)
(407) 826-0111
Entity
Organization
Contact information
Practice address
14055 TOWN LOOP BLVD, STE 100, ORLANDO, FL 32837-6105
(407) 826-0111
(407) 851-4208
Mailing address
14055 TOWN LOOP BLVD, STE 100, ORLANDO, FL 32837-6105
(407) 826-0111
(407) 851-4208
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN13313
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074375500
—
FL
Enumeration date
01/10/2011
Last updated
01/10/2011
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