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Organization

TRUE VINE DENTAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHADY ASHAMALLA D.D.S. (OWNER/DENTIST)
(602) 481-0153
Entity
Organization

Contact information

Practice address
2633 W STATE ROAD 434, LONGWOOD, FL 32779-4878
(602) 481-0153
Mailing address
3051 ZAHARIAS DR, ORLANDO, FL 32837-7025

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
05/17/2024
Last updated
05/17/2024
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