Lake Village Dental
NPI #1760073217 in Fruitland Park, Florida
Provider Information
- NPI Number
- 1760073217
- Entity Type
- Organization
- Organization Name
- Lake Village Dental
- Primary Specialty
- Dentist - Dental Public Health
- Enumeration Date
- Jan 28, 2021
- Last Updated
- Jan 28, 2021
Practice Location
- Address
- 3261 S US HIGHWAY 27 # 441E-1
- City
- Fruitland Park
- State
- Florida
- ZIP Code
- 34731-4497
- Phone
- (352) 314-2729
Authorized Official
- Name
- DR. VAMSI KALLEPALLI, DMD
- Title
- DENTIST
- Phone
- (352) 314-2729
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Dental Public Health — Dental Public Health |
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