Provider Demographics
NPI:1760986509
Name:WINTER SPRINGS FAMILY DENTAL, P.A.
Entity Type:Organization
Organization Name:WINTER SPRINGS FAMILY DENTAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLANES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-613-2615
Mailing Address - Street 1:4755 HIGHWAY A1A
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-5402
Mailing Address - Country:US
Mailing Address - Phone:772-231-6004
Mailing Address - Fax:772-231-7249
Practice Address - Street 1:5220 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-4912
Practice Address - Country:US
Practice Address - Phone:772-231-6004
Practice Address - Fax:772-231-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN202541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty