Organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Active
Parent organization
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Other names
Lifetime Dentistry of Port Orange
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
5445 S. WILLIAMSON BLVD, PORT ORANGE, FL 32128
(386) 267-6202
Mailing address
5445 S. WILLIAMSON BLVD, PORT ORANGE, FL 32128
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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