Organization
ECONOMY DENTISTRY FOR CHILDREN - DUPONT STATION, LLC
Active
Parent organization
ECONOMY DENTISTRY FOR CHILDREN - DUPONT STATION, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ECONOMY DENTISTRY FOR CHILDREN - DUPONT STATION, LLC
Authorized official
LEROY R. POLITE (PRESIDENT)
(904) 683-1769
Entity
Organization
Contact information
Practice address
1319 E OSCEOLA PKWY STE C, KISSIMMEE, FL 34744-1606
(904) 683-1769
(904) 900-1243
Mailing address
3615 DUPONT AVE STE 200-400, JACKSONVILLE, FL 32217-2790
(904) 683-1769
(904) 900-1243
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/26/2019
Last updated
07/11/2019
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