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Organization

HIGHLAND PARK DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICAL SLATER DMD (PREIDENT)
(863) 644-6418
Entity
Organization

Contact information

Practice address
4326 HIGHLAND PARK BLVD, LAKELAND, FL 33813-1647
(863) 644-6418
(863) 644-6419
Mailing address
4326 HIGHLAND PARK BLVD, LAKELAND, FL 33813-1647
(863) 644-6418
(863) 644-6419

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN18120
FL

Other

Enumeration date
09/28/2015
Last updated
09/28/2015
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