Provider Demographics
NPI:1992497002
Name:DENTAL FIRST CARE 2 PA
Entity type:Organization
Organization Name:DENTAL FIRST CARE 2 PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-857-8585
Mailing Address - Street 1:9753 S ORANGE BLOSSOM TRL STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8998
Mailing Address - Country:US
Mailing Address - Phone:407-857-8585
Mailing Address - Fax:
Practice Address - Street 1:5810 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-6107
Practice Address - Country:US
Practice Address - Phone:407-857-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty