Organization
DENTISTRY OF KISSIMMEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL JIMENEZ (CHIEF OPERATING OFFICER)
(407) 529-6814
Entity
Organization
Contact information
Practice address
2721 MICHIGAN AVE, KISSIMMEE, FL 34744-1551
(407) 847-0111
Mailing address
11063 MOBBERLEY CIR, ORLANDO, FL 32832-6965
(407) 312-1338
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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