Organization
ALFONSO CRUZ DMD PA
Active
Parent organization
ALFONSO CRUZ DMD PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALFONSO CRUZ DMD PA
Authorized official
DR. ALFONSO CRUZ DMD (DENTIST)
(386) 631-6471
Entity
Organization
Contact information
Practice address
1657 TAYLOR RD STE 106, PORT ORANGE, FL 32128-7516
(386) 631-6471
Mailing address
1657 TAYLOR RD STE 106, PORT ORANGE, FL 32128-7516
(386) 631-6471
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2022
Last updated
05/16/2022
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