Sage Dental of Lake Mary Pllc

NPI #1043674872 in Lake Mary, Florida

Provider Information

NPI Number: 1043674872
Entity Type: Organization
Organization Name: Sage Dental of Lake Mary Pllc
Primary Specialty: Dentist
Enumeration Date: Apr 7, 2016
Last Updated: Apr 19, 2017

Practice Location

Address: 3801 W LAKE MARY BLVD
Address 2: SUITE 111
City: Lake Mary
State: Florida
ZIP Code: 32746-6159
Phone: (407) 936-3400

Authorized Official

Name: ANTONIO CRUZ, DMD
Title: CHIEF DENTAL DIRECTOR
Phone: (561) 999-9650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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