Provider Demographics
NPI:1386832376
Name:METRO ORLANDO DENTAL LLC
Entity Type:Organization
Organization Name:METRO ORLANDO DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-299-6480
Mailing Address - Street 1:7244 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-6749
Mailing Address - Country:US
Mailing Address - Phone:407-299-6480
Mailing Address - Fax:407-297-7077
Practice Address - Street 1:7244 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6749
Practice Address - Country:US
Practice Address - Phone:407-299-6480
Practice Address - Fax:407-297-7077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8447122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty