Organization · Type 2 NPI
Envision Dental Services PA
Dental Clinic/Center · Port Orange, FL
NPI number
1629861661
Active
Practice location
870 Dunlawton Ave Ste 110
Port Orange, FL 32127-9274
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
| Customized Equipment (DME) | 332BC3200X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1629861661
Envision Dental Services PA's National Provider Identifier is 1629861661, issued on May 23, 2025. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Port Orange, FL. The record was last updated on May 23, 2025.