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Organization

FL SOUTHERN DENTAL PPO PA

Active
Parent organization
FL SOUTHERN DENTAL PPO PA
Other names
All About Smiles
Organization subpart
Yes

Provider details

NPI number
Legal business name
FL SOUTHERN DENTAL PPO PA
Authorized official
ERIKA MELISSA MENJIVAR (SR. CREDENTIALING SPECIALIST)
(469) 596-6137
Entity
Organization

Contact information

Practice address
4089 TAMIAMI TRL N STE A101, NAPLES, FL 34103-3574
(239) 434-5525
Mailing address
5830 GRANITE PKWY STE 780, PLANO, TX 75024-6775

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
07/01/2026
Last updated
07/01/2026
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