Provider Demographics
NPI:1699548206
Name:HAMLIN PERIODONTICS AND IMPLANT DENTISTRY PLLC
Entity type:Organization
Organization Name:HAMLIN PERIODONTICS AND IMPLANT DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-504-0689
Mailing Address - Street 1:3306 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-3824
Mailing Address - Country:US
Mailing Address - Phone:305-450-8929
Mailing Address - Fax:
Practice Address - Street 1:15415 WATERBIRD RD STE D
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5787
Practice Address - Country:US
Practice Address - Phone:407-504-0689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental