Organization
HUNTERS CREEK DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER KELLY (OWNER)
(410) 410-3031
Entity
Organization
Contact information
Practice address
14009 EGRET TOWER DR, ORLANDO, FL 32837-6197
(407) 251-5100
Mailing address
14009 EGRET TOWER DR, ORLANDO, FL 32837-6197
(407) 251-5100
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN19430
STATE LICENSE
FL
Enumeration date
02/18/2021
Last updated
02/18/2021
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