Wildwood Modern Dentistry, PA

NPI #1063222149 in Wildwood, Florida

Provider Information

NPI Number: 1063222149
Entity Type: Organization
Organization Name: Wildwood Modern Dentistry, PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 10, 2025
Last Updated: Jan 10, 2025

Practice Location

Address: 5297 SUNDANCE TRL
City: Wildwood
State: Florida
ZIP Code: 34785-7717
Phone: (352) 663-9773

Authorized Official

Name: JERIN JOSEPH
Title: OWNER
Phone: (714) 845-8500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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