Organization
D & G DENTAL SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTINA DOMINQUEZ DMD (OWNER)
(352) 296-1800
Entity
Organization
Contact information
Practice address
13171 CORTEZ BLVD, BROOKSVILLE, FL 34613
(352) 296-1800
Mailing address
PO BOX 3189, SYRACUSE, NY 13220
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17518
FL
Other
Enumeration date
04/24/2009
Last updated
04/24/2009
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