Organization
ADVANCED PARK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITESH JIVAN DMD (OWNER/DENTIST)
(407) 628-0200
Entity
Organization
Contact information
Practice address
329 N PARK AVE, SUITE #360, WINTER PARK, FL 32789-7408
(407) 628-0220
Mailing address
329 N PARK AVE, SUITE #360, WINTER PARK, FL 32789-7408
(407) 628-0220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18726
FL
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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