Genesis Dental Group Smiles On 11th LLC
NPI #1629598750 in Panama City, Florida
Provider Information
- NPI Number
- 1629598750
- Entity Type
- Organization
- Organization Name
- Genesis Dental Group Smiles On 11th LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 20, 2017
- Last Updated
- Jun 20, 2017
Practice Location
- Address
- 1010 W 11TH ST
- City
- Panama City
- State
- Florida
- ZIP Code
- 32401-2042
- Phone
- (850) 763-3622
Authorized Official
- Name
- SUSAN STEWART
- Title
- MANAGER
- Phone
- (334) 676-2320
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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