Provider Demographics
NPI:1881600211
Name:EAST COLONIAL DENTAL GROUP
Entity type:Organization
Organization Name:EAST COLONIAL DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FROILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARINAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-228-2251
Mailing Address - Street 1:4401 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5200
Mailing Address - Country:US
Mailing Address - Phone:407-228-2251
Mailing Address - Fax:407-228-2252
Practice Address - Street 1:4401 E COLONIAL DR
Practice Address - Street 2:SUITE 108
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5200
Practice Address - Country:US
Practice Address - Phone:407-228-2251
Practice Address - Fax:407-228-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL148061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty