Southern Dental LLC

NPI #1710004171 in Ocoee, Florida

Provider Information

NPI Number: 1710004171
Entity Type: Organization
Organization Name: Southern Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 23, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 2560 MAGUIRE RD
City: Ocoee
State: Florida
ZIP Code: 34761-4749
Phone: (407) 656-5700

Authorized Official

Name: CARY FREEMAN
Title: INSURANCE COUNSLER
Phone: (407) 656-5700

Specialties & Taxonomy Codes

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

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