Provider Demographics
NPI:1720243116
Name:ACUNA, EDGAR SILVIO (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:SILVIO
Last Name:ACUNA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4741
Mailing Address - Country:US
Mailing Address - Phone:407-647-6261
Mailing Address - Fax:407-647-5029
Practice Address - Street 1:1100 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4741
Practice Address - Country:US
Practice Address - Phone:407-647-6261
Practice Address - Fax:407-647-5029
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN132441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice