Organization · Type 2 NPI
DT Clinical Port ST Lucie
Prosthodontics · Port St. Lucie, FL
NPI number
1407775000
Active
Practice location
1214 SW Gatlin Blvd Unit 103
Port St. Lucie, FL 34953-4216
Fax (561) 922-7001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prosthodontics Primary | 1223P0700X | None listed |
Prosthodontics: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
About NPI 1407775000
DT Clinical Port ST Lucie's National Provider Identifier is 1407775000, issued on Jul 15, 2026. The primary taxonomy on file is Prosthodontics (1223P0700X), and the practice location is in Port St. Lucie, FL. The record was last updated on Jul 15, 2026.