Organization
WEST ORANGE DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEJUMADE ST MATTHEW-DANIELS DMD (OWNER)
(409) 290-9588
Entity
Organization
Contact information
Practice address
217 N KIRKMAN RD, SUITE 3, ORLANDO, FL 32811-1186
(407) 290-9588
Mailing address
217 N KIRKMAN RD, SUITE 3, ORLANDO, FL 32811-1186
(407) 290-9588
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
DN16856
FL
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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