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Organization

AZGAN DENTAL MANAGEMENT COMPANY PLLC

Active
Other names
Lucie Dental Specialists
Organization subpart
No

Provider details

NPI number
Authorized official
SUZEL GONZALEZ (BILLING DIRECTOR)
(772) 812-4903
Entity
Organization

Contact information

Practice address
1465 NW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1968
(772) 348-4403
Mailing address
1465 NW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1968
(772) 348-4403

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1223G0001X
General Practice Dentistry
1223P0300X
Periodontics

Other

Enumeration date
09/30/2022
Last updated
09/30/2022
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