Fl Southern Dental PA
NPI #1720970569 in New Smyrna Beach, Florida
Provider Information
- NPI Number
- 1720970569
- Entity Type
- Organization
- Organization Name
- Fl Southern Dental PA
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- FL SOUTHERN DENTAL PA
- Primary Specialty
- Dentist
- Enumeration Date
- Jul 16, 2025
- Last Updated
- Jul 16, 2025
Practice Location
- Address
- 382 N CAUSEWAY
- City
- New Smyrna Beach
- State
- Florida
- ZIP Code
- 32169-5233
- Phone
- (386) 428-6468
Authorized Official
- Name
- ERIKA MELISSA MENJIVAR
- Title
- SR. CREDENTIALING SPECIALIST
- Phone
- (469) 596-6137
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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