Organization
ADVANCED DENTAL INC.
Active
Other names
Advanced Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS O. SOTO D.M.D. (PRESIDENT)
(386) 322-7786
Entity
Organization
Contact information
Practice address
1525 HERBERT ST, SUITE 101, PORT ORANGE, FL 32129-6106
(386) 322-7786
(386) 761-3920
Mailing address
1525 HERBERT ST, SUITE 101, PORT ORANGE, FL 32129-6106
(386) 322-7786
(386) 761-3920
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN12614
FL
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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