Organization
ENVISION DENTAL SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALINE BOWERS (OWNER)
(386) 256-4786
Entity
Organization
Contact information
Practice address
870 DUNLAWTON AVE STE 110, PORT ORANGE, FL 32127-9274
(386) 256-4786
Mailing address
870 DUNLAWTON AVE STE 110, PORT ORANGE, FL 32127-9274
(386) 256-4786
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/23/2025
Last updated
05/23/2025
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