Provider Demographics
NPI:1912315524
Name:SAINT APOLLONIA PLLC
Entity Type:Organization
Organization Name:SAINT APOLLONIA PLLC
Other - Org Name:EVEREST DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:N
Authorized Official - Last Name:GAYED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-695-7774
Mailing Address - Street 1:2989 ALAFAYA TRL
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9493
Mailing Address - Country:US
Mailing Address - Phone:407-695-7774
Mailing Address - Fax:
Practice Address - Street 1:2989 ALAFAYA TRL
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9493
Practice Address - Country:US
Practice Address - Phone:407-695-7774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 20614122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty