Organization
LIGHTHOUSE DENTAL STUDIO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN COLAIANNI DMD (OWNER/DENTIST)
(407) 961-2821
Entity
Organization
Contact information
Practice address
206 ASHOURIAN AVE UNIT 217-218, ST AUGUSTINE, FL 32092-5108
(407) 961-2821
Mailing address
206 ASHOURIAN AVE UNIT 217-218, ST AUGUSTINE, FL 32092-5108
(407) 961-2821
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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