Organization
KREATIVE DENTAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YALICE MARIELY CARDONA DMD (PRESIDENT)
(787) 552-2631
Entity
Organization
Contact information
Practice address
120 CARTER BLVD STE 7, POLK CITY, FL 33868-8912
(863) 984-0000
Mailing address
120 CARTER BLVD STE 7, POLK CITY, FL 33868-8912
(863) 984-0000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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