Provider Demographics
NPI:1922487750
Name:AMA DENTAL SERVICES, LLC
Entity Type:Organization
Organization Name:AMA DENTAL SERVICES, LLC
Other - Org Name:POINCIANA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-201-7910
Mailing Address - Street 1:4671 OLD PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3423
Mailing Address - Country:US
Mailing Address - Phone:407-201-7910
Mailing Address - Fax:407-201-7911
Practice Address - Street 1:4671 OLD PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3423
Practice Address - Country:US
Practice Address - Phone:407-201-7910
Practice Address - Fax:407-201-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental