Provider Demographics
NPI:1063594802
Name:OVIEDA DENTAL CENTER
Entity type:Organization
Organization Name:OVIEDA DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEOANE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-366-2363
Mailing Address - Street 1:2959 ALAFAYA TRAIL STE 109
Mailing Address - Street 2:OVIEDO DENTAL CENTER
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765
Mailing Address - Country:US
Mailing Address - Phone:407-366-2363
Mailing Address - Fax:407-366-9564
Practice Address - Street 1:2959 ALAFAYA TRAIL STE 109
Practice Address - Street 2:OVIEDO DENTAL CENTER
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765
Practice Address - Country:US
Practice Address - Phone:407-366-2363
Practice Address - Fax:407-366-9564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty