Organization
TREVISANI ORAL SURGERY THE VILLAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI VARGAS (OFFICE MANAGER)
(407) 886-2050
Entity
Organization
Contact information
Practice address
929 N HWY 441, SUITE 302, LADY LAKE, FL 32159
(352) 751-5100
(407) 886-2117
Mailing address
929 N US HIGHWAY 441, LADY LAKE, FL 32159-3001
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN13576
FL
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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