Organization
CDPG, P.L.
Active
Parent organization
CDPG, P.L.
Other names
Miracle City Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
CDPG, P.L.
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
696 COUNTRY CLUB DR, TITUSVILLE, FL 32780-4977
(321) 383-7828
Mailing address
696 COUNTRY CLUB DR, TITUSVILLE, FL 32780-4977
(321) 383-7828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
07/14/2025
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