Organization
THE TOOTH SHOP ON 46
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA SYSKA (PRACTICE MANAGER)
(352) 391-4231
Entity
Organization
Contact information
Practice address
25520 STATE ROAD 46, SORRENTO, FL 32776-9526
(352) 735-2211
(352) 735-5844
Mailing address
25520 STATE ROAD 46, SORRENTO, FL 32776-9526
(352) 735-2211
(352) 735-5844
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/17/2022
Last updated
01/17/2022
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