Organization
LASTING SMILES OF KISSIMMEE LLC
Active
Other names
COLUMBIA DENTAL CARE AND ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
DHARAM TAYAL (MEMBER)
(716) 239-5889
Entity
Organization
Contact information
Practice address
1135 W COLUMBIA AVE, KISSIMMEE, FL 34741-3202
(407) 933-4343
Mailing address
1135 W COLUMBIA AVE, KISSIMMEE, FL 34741-3202
(407) 933-4343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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