Provider Demographics
NPI:1205046810
Name:SUNSHINE FAMILY DENTISTRY
Entity type:Organization
Organization Name:SUNSHINE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:OXER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-465-2037
Mailing Address - Street 1:408 W INTERLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-0700
Mailing Address - Country:US
Mailing Address - Phone:863-465-2037
Mailing Address - Fax:863-465-1155
Practice Address - Street 1:408 W INTERLAKE BLVD
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-0700
Practice Address - Country:US
Practice Address - Phone:863-465-2037
Practice Address - Fax:863-465-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 152211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty