The Tooth Shop On 46

NPI #1932850385 in Sorrento, Florida

Provider Information

NPI Number: 1932850385
Entity Type: Organization
Organization Name: The Tooth Shop On 46
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jan 17, 2022
Last Updated: Jan 17, 2022

Practice Location

Address: 25520 STATE ROAD 46
City: Sorrento
State: Florida
ZIP Code: 32776-9526
Phone: (352) 735-2211

Authorized Official

Name: MRS. DANA SYSKA
Title: PRACTICE MANAGER
Phone: (352) 391-4231

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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