Organization
AEGEAN DENTAL OF PORT ST LUCIE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE SOROPOULOS DDS, BSME (MANAGER)
(561) 395-1486
Entity
Organization
Contact information
Practice address
308 NW BETHANY DR, PORT ST LUCIE, FL 34986-3578
(772) 344-4356
Mailing address
2151 NW 2ND AVE, 101, BOCA RATON, FL 33431-6771
(561) 395-1486
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15874
FL
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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