Organization
CAROLINA DENTURES & DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REYNALDO FAVALA GONZALEZ DMD (OWNER OPERATOR)
(352) 489-0707
Entity
Organization
Contact information
Practice address
10701 US HWY 41 NORTH DUNNELLON, DUNNELLON, FL 34432
(352) 489-0707
(352) 489-1525
Mailing address
PO BOX 538, 10701 US HWY 41 NORTH DUNNELLON, DUNNELLON, FL 34432
(352) 489-0707
(352) 489-1525
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN0011269
FL
Other
Enumeration date
09/26/2006
Last updated
08/22/2020
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