Provider Demographics
NPI:1740629203
Name:WESTMORELAND DENTAL, LLC
Entity type:Organization
Organization Name:WESTMORELAND DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTMORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-977-7797
Mailing Address - Street 1:1941 W COUNTY ROAD 419
Mailing Address - Street 2:SUITE #1061
Mailing Address - City:CHULUOTA
Mailing Address - State:FL
Mailing Address - Zip Code:32766-9554
Mailing Address - Country:US
Mailing Address - Phone:407-977-7797
Mailing Address - Fax:
Practice Address - Street 1:1941 W COUNTY ROAD 419
Practice Address - Street 2:SUITE #1061
Practice Address - City:CHULUOTA
Practice Address - State:FL
Practice Address - Zip Code:32766-9554
Practice Address - Country:US
Practice Address - Phone:407-977-7797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN171801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty