Organization
CONWAY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN NICHOLSON (OFFICE MANAGER)
(407) 894-2048
Entity
Organization
Contact information
Practice address
3862 CURRY FORD RD, ORLANDO, FL 32806-2708
(407) 894-2048
(407) 898-5643
Mailing address
3862 CURRY FORD RD, ORLANDO, FL 32806-2708
(407) 894-2048
(407) 898-5643
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
DN10824
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072567600
—
FL
Enumeration date
10/03/2012
Last updated
10/03/2012
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