Organization
CHILDREN AND TEEN ORTHO GROUP OF FLORIDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SMITH (CHIEF OFFICER)
(770) 231-5348
Entity
Organization
Contact information
Practice address
3885 S FLORIDA AVE, LAKELAND, FL 33813-1109
(863) 333-0397
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(470) 207-3264
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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