Organization
IDEAL DENTAL OF CLERMONT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA COUSSA DMD (OWNER)
(972) 331-8079
Entity
Organization
Contact information
Practice address
2612 S HWY 27 STE 600, CLERMONT, FL 34711-6521
(407) 965-0090
Mailing address
PO BOX 840925, DALLAS, TX 75284-0925
(972) 361-0600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
10/02/2023
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