Delta Dental PPO Dentist Listing for Florida - Miami-Dade County

Delta Dental PPO Dentist Listing for Florida

This directory contains the names of Delta Dental PPO dentists in your region, in order by county, then by city.

You may obtain treatment from any dentist, but if you select a Delta Dental dentist, he or she has agreed to provide treatment according to the provisions of your plan. For example, Delta Dental dentists complete claim forms and submit them directly to Delta Dental. Your plan benefit booklet lists your benefits, limitations and exclusions, and explains coinsurance costs that are your responsibility.

If you select a non-Delta Dental dentist, the dental bill is your responsibility. Upon your submission of a completed claim form, Delta Dental will pay allowable amounts in accordance with the provisions of your plan as outlined in your benefit booklet.

If you are covered by the Delta Dental PPO plan, you will generally receive a higher level of benefits by going to a Delta Dental PPO network dentist. PPO dentists are noted in this directory by an asterisk (*) in the column to the left of the dentist's name. You will also receive Delta Dental PPO in-network benefits when you go to any endodontist, oral surgeon or periodontist who is listed in this directory.

Please note that there may have been changes since the publication date of this directory. Therefore, we strongly recommend that you ask your dentist about his or her current status with Delta Dental. For a current list of Delta Dental dentists in your area, use our online directory through our web site at .

Broward providers = start on page 8

Miami-Dade Providers = start on page 106

Key to dental specialty codes:

00 General dentists provide a full range of services for the entire family. 10 Oral surgeons remove impacted teeth and repair fractures of the jaw and other damage to the bone structure around the mouth. 15 Endodontists specialize in diseases of the tooth pulp, performing such services as root canals. 20 Orthodontists correct misaligned teeth and jaws, usually by applying braces. 30 Pediatric dentists generally limit their practices to children and teenagers. 40 Periodontists treat diseases of the tissues that support and surround the teeth 50 Prosthodontists generally specialize in replacing missing natural teeth with bridges and dentures. 60 Oral pathologists diagnose diseases of the mouth from study of tissue samples.

Spec. Code Alachua

00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 15 00 00 00 00 00 00 00 00 15 15 00 00 00 00 00 00 20 00 00 00 00

T0e5/x2t04167:

Name

Address

City

State Zip

Phone

Goslinga, Cody Goslinga, Shane Lazo, Amanda Tabis, Lauren Abboud, Maria Abboud, Maria Abolverdi, Shaun Abolverdi, Shaun Abraben, Reeve Annas, Samantha Annas, Samantha Atkinson, William Atwal, Manveen Ayala, Valentina Baluyot, Rondre Banfield, Gary Bangash, Maryam Bernstein, Duane Blanco, Raquel Buechele, Manfred Busch, Dianne Davila Rivera, Jose Davis, Quinta Day, Jennifer Day, Ralph De La Rosa, Andrew Dean, Glenn Dean, Glenn Diasti, Adam Dickinson, Scott Dixon, Raymond Dominguez, Cristina Estes, Joshua Farah, John Fields, Robert Garcia, Jessica Gerber, Dale Gerber, Dale Gesicki, Jon

14690 NW 151st Blvd # 20 14690 NW 151st Blvd # 20 14690 NW 151st Blvd # 20 14690 NW 151st Blvd # 20 3731 NW 40th Terrace Ste A 908 NW 57th St 6320 SW 13th St 9200 NW 39th Ave Ste 200 9200 NW 39th Ave Ste 200 3731 NW 40th Terrace Ste A 908 NW 57th St 6921 W Newberry Rd 3731 NW 40th Terrace Ste A 4404 NW 36th Ave 6110 NW 1st Pl Ste A 5347 SW 91st Ter # B 6921 W Newberry Rd 5318 SW 91st Ter Ste C 5622 NW 43rd St 3731 NW 40th Ter Ste A 7733 W Newberry Rd Ste B3 4001 W Newberry Rd Ste B4 6921 W Newberry Rd 1410 NW 13th St Ste 8 1410 NW 13th St Ste 8 6921 W Newberry Rd 340 NW 76th Dr 4650 NW 39th Pl Ste I 1010 NW 76th Blvd 6921 W Newberry Rd 6921 W Newberry Rd 6921 W Newberry Rd 6921 W Newberry Rd 6921 W Newberry Rd 5021 NW 34th Blvd Ste A 6921 W Newberry Rd 3731 NW 40th Terrace Ste A 908 NW 57th St 6921 W Newberry Rd

Alachua Alachua Alachua Alachua Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville

FL 32615 (386) 462-1771 FL 32615 (386) 462-1771 FL 32615 (386) 462-1771 FL 32615 (386) 462-1771 FL 32606 (352) 376-6366 FL 32605 (352) 332-8199 FL 32608 (352) 373-3431 FL 32606 (352) 376-8229 FL 32606 (352) 376-8229 FL 32606 (352) 376-6366 FL 32605 (352) 332-8199 FL 32605 (352) 333-7788 FL 32606 (352) 376-6366 FL 32606 (352) 376-5120 FL 32607 (352) 331-1004 FL 32608 (352) 375-6116 FL 32605 (352) 333-7788 FL 32608 (352) 374-2999 FL 32653 (352) 378-3139 FL 32606 (352) 376-6366 FL 32606 (352) 331-4700 FL 32607 (352) 377-8678 FL 32605 (352) 333-7788 FL 32601 (352) 376-8207 FL 32601 (352) 376-8207 FL 32605 (352) 333-7788 FL 32607 (352) 331-3113 FL 32606 (352) 373-1040 FL 32606 (352) 332-4180 FL 32605 (352) 333-7788 FL 32605 (352) 333-7788 FL 32605 (352) 333-7788 FL 32605 (352) 333-7788 FL 32605 (352) 333-7788 FL 32605 (352) 371-7766 FL 32605 (352) 333-7788 FL 32606 (352) 376-6366 FL 32605 (352) 332-8199 FL 32605 (352) 333-7788

Lists of Delta Dental dentists and benefit and eligibility information are also available on our web site: .

Page 1

Spec. Code 00 15 30 30 30 30 15 10 00 00 00 00 00 00 00 00 00 15 00 00 15 15 00 00 00 10 00 00 00 00 00 00 15 15 00 00 10 30 30 20 00 00 00 00 00 00 00 00 00 00 20 00 00 15 00 00 00 00 00 20 00 00 00 10 10 15 15 20 00 00 00 30 00 30 00 30 00

T0e5/x2t04167:

Name

Address

City

State Zip

Phone

Godet, Yvette Goldfaden, Stephen Gooch, Andrew Gooch, Andrew Gooch, Michael Gooch, Michael Gracy, Megan Graper, Charles Greenwalt, Brandon Greenwalt, Brandon Grigoryan, Armen Hasan, Farah Havens, Nancy Heald, Katie Hill, Cara Johary, Edwin Ju, Sujin Jurecko, Kevin Kalifeh, Robert Keen, Ashley Kerr, Carolyn Kerr, Carolyn Klein, Nicole Krotzinger, Mary Ku-Torres, Mario Latham, Christopher Lemus, Analidys Listzwan, James Lopez, Melvin Lotfi, Ramzy Maloney, Janet Marius, Jean Mary Markham, Samuel Markham, Samuel McCaully Rennie, Jasmine McDonough, Lauren Milton Jr, Charles Mixon, Robert Mixon, Robert Mullally, Natalie Neira, Fernando Nguyen, Sabrina Onate, Mairelys Pages, Elizabetha Pairot, Alfredo Paladino, James Park, Jong Yun Pastora, Yocasta Patel, Daven Patel, Mili Pavlik, Stephen Perez, Edna Peterson, Savanna PETROPOULOS, TERRYL Pirkle, Patrick Rosado, Nahir Saladi, Srikanthi Saladi, Srikanthi Sanchez, Jairo Sappington, Deborah Schwibner, Jenna Shaikh, Abdul Son, Minsung Storoe, William Torres, Ernesto Tyler, Kathy Tyler, Kathy Vargas, Enrigue Witt, William Dennis, Ian Hunter, Damien Moore, Ronda Nerikar, Vivekanand Perry, Susana Gleeson Hill, Charlotte Johnston, Allison Listzwan, James

126 NW 76th Dr Ste A 1905 NW 13th St Ste 2 4910 NW 27th Ct 5209 SW 91st Dr 4910 NW 27th Ct 5209 SW 91st Dr 1204 NW 69th Ter Ste C 832 NW 57th St 410 NE Waldo Rd 5347 SW 91st Ter Ste B 6921 W Newberry Rd 6921 W Newberry Rd 6921 W Newberry Rd 6921 W Newberry Rd 1204 NW 69th Ter Ste E 1831 NW 13th St Ste 4 150 NW 75th Dr Ste B 1204 NW 69th Ter Ste C 410 NE Waldo Rd 6921 W Newberry Rd 340 NW 76th Dr 4650 NW 39th Pl Ste I 6921 W Newberry Rd 410 NE Waldo Rd 5180 SW 34th St 6921 W Newberry Rd 6921 W Newberry Rd 4001 W Newberry Rd Ste B1 410 NE Waldo Rd 6921 W Newberry Rd 5622 NW 43rd St 6921 W Newberry Rd 340 NW 76th Dr 4650 NW 39th Pl Ste I 6921 W Newberry Rd 6921 W Newberry Rd 6921 W Newberry Rd 4910 NW 27th Ct 5209 SW 91st Dr 2222 NW 40 Terrace #B 6921 W Newberry Rd 6921 W Newberry Rd 410 NE Waldo Rd 6921 W Newberry Rd 410 NE Waldo Rd 1204 NW 69th Ter Ste E 6921 W Newberry Rd 2602 SW 87th Dr Ste 101 6921 W Newberry Rd 6110 NW 1st Pl Ste A 5010 W Newberry Rd Ste B 2602 SW 87th Dr Ste 101 6921 W Newberry Rd 6110 NW 1st Pl Ste A 230 NW 76th Dr Ste B 4436 NW 23rd Ave 1010 NW 76th Blvd 5021 NW 34th Blvd Ste A 5021 NW 34th Blvd Ste A 9161 SW 49th Pl 6921 W Newberry Rd 6110 NW 1st Pl Ste A 6921 W Newberry Rd 3500 SW 2nd Ave Ste 2 6921 W Newberry Rd 340 NW 76th Dr 4650 NW 39th Pl Ste I 2841 NW 41st St 9200 NW 39th Ave Ste 200 18474 Main St 14029 W Newberry Rd Unt 60 231 NW 137th Dr 175 NW 138th Ter Ste 200 231 NW 137th Dr 13820 W Newberry Rd Ste 100 13820 W Newberry Rd Ste 100 12 SW 250th St

Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville Gainesville High Springs Jonesville Jonesville Jonesville Jonesville Newberry Newberry Newberry

FL 32607 FL 32609 FL 32606 FL 32608 FL 32606 FL 32608 FL 32605 FL 32605 FL 32641 FL 32608 FL 32605 FL 32605 FL 32605 FL 32605 FL 32605 FL 32609 FL 32607 FL 32605 FL 32641 FL 32605 FL 32607 FL 32606 FL 32605 FL 32641 FL 32608 FL 32605 FL 32605 FL 32607 FL 32641 FL 32605 FL 32653 FL 32605 FL 32607 FL 32606 FL 32605 FL 32605 FL 32605 FL 32606 FL 32608 FL 32605 FL 32605 FL 32605 FL 32641 FL 32605 FL 32641 FL 32605 FL 32605 FL 32608 FL 32605 FL 32607 FL 32607 FL 32608 FL 32605 FL 32607 FL 32607 FL 32606 FL 32606 FL 32605 FL 32605 FL 32608 FL 32605 FL 32607 FL 32605 FL 32607 FL 32605 FL 32607 FL 32606 FL 32606 FL 32606 FL 32643 FL 32669 FL 32669 FL 32669 FL 32669 FL 32669 FL 32669 FL 32669

Lists of Delta Dental dentists and benefit and eligibility information are also available on our web site: .

(352) 333-9898 (352) 375-7776 (352) 335-7777 (352) 335-7777 (352) 335-7777 (352) 335-7777 (352) 332-3788 (352) 331-6661 (352) 375-3790 (352) 375-6116 (352) 333-7788 (352) 333-7788 (352) 333-7788 (352) 333-7788 (352) 331-9992 (352) 377-0360 (352) 333-9898 (352) 332-3788 (352) 375-3790 (352) 333-7788 (352) 331-3113 (352) 373-1040 (352) 333-7788 (352) 375-3790 (352) 372-5550 (352) 333-7788 (352) 333-7788 (352) 376-6330 (352) 375-3790 (352) 333-7788 (352) 378-3139 (352) 333-7788 (352) 331-3113 (352) 373-1040 (352) 333-7788 (352) 333-7788 (352) 333-7788 (352) 335-7777 (352) 335-7777 (352) 336-2222 (352) 333-7788 (352) 333-7788 (352) 375-3790 (352) 333-7788 (352) 375-3790 (352) 331-9992 (352) 333-7788 (352) 331-4731 (352) 333-7788 (352) 331-1004 (352) 376-5055 (352) 331-4731 (352) 333-7788 (352) 331-1004 (352) 333-0441 (352) 376-3216 (352) 332-4180 (352) 371-7766 (352) 371-7766 (352) 378-2545 (352) 333-7788 (352) 331-1004 (352) 333-7788 (352) 371-4111 (352) 333-7788 (352) 331-3113 (352) 373-1040 (999) 999-9999 (352) 376-8229 (386) 454-1412 (352) 872-5930 (352) 316-7400 (352) 332-3080 (352) 316-7400 (352) 371-3200 (352) 371-3200 (352) 472-4444

Page 2

Spec. Code

Baker

00

Bay

10 00 00 00 00 00 30 00 30 30 00 00 00 00 10 00 15 15 00 00 30 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 30 00 00 00 00 00 00 00 00 00 00 00 00 00 00

Bradford

00 00 00 00 Brevard

15 00 15 00 00 00 00 15 15 00 00 00 00 15 15

Name

Carter, Derrick

Heitzmann, Scott Abdulrahim, Yahia Abdulrahim, Yahia Abdulrahim, Yahia Azam, Shabana Baptiste, Ashley Berry, Stephen Claussen, Meghann Claussen, Peter Claussen, Peter Collias, John Elzawahry, Arzu Elzawahry, Tamam Elzawahry, Tarek Grantham, Gregory Griffin, Tara Hanson, Shane Harrison, Rex Harrison, William Heikowsky II, Robert LaPointe, Lisa Moffa, Michelle Mostafa, Sherin Norton, Andrew Paiva, Heber Paiva, Jose Pankuch, Richard Pappas, Trae Pascoli, Jenna Pate, Sheena Patel, Anishkumar Piorkowski, Gary Salter, Patricia Shumpert Jr, William Stamps, Elizabeth Thompson, Krista Ticola, Matthew Waheed, Abdul Wilhite, Rhonda Wright, Carl Arrington, Prince Baya, Stephanie Dubois, Ashley Graves, Carl Heath, Nicklaus Lichorwic, Dennis Ligeon, Valerie Morshed, Aly Skinner, Julia Waits, Nisha White, Benjamin

Hunter, Damien Carballo, Lindsey Cunningham, Talisha Flynn, George

Deshpande, Annapurna Kearney, Deborah Kearney, Wayne Boers, David Cardoso, Gary Che, David Eley, Daniel Hachmeister, Darlene Hernandez, Ramon Kahlon, Erin Kalra, Anjay Quinter, William Shah, Anand Simons, Javier Sisson, Tavis

Address

City

571 S 6th St

Macclenny

725 Ohio Ave 2335 State Ave Ste A 403 E 11th St 431 W Oak Ave 403 E 11th St 403 E 11th St 3123 W 23rd St 403 E 11th St 2636 Jenks Ave 3123 W 23rd St 45 E Beach Dr 1560 Jenks Ave 1560 Jenks Ave 311 Airport Rd 340 W 23rd St Ste A 3135 Thomas Dr 2999 W 10th St 1615 Harrison Ave 1012 W 11th St 8730 Thomas Dr Ste 1102 3123 W 23rd St 403 E 11th St 340 W 23rd St Ste C 403 E 11th St 2309A St. Andrews Blvd 2309A St. Andrews Blvd 403 E 11th St 1022 Harrison Ave 2620 Jenks Ave 403 E 11th St 1022 Harrison Ave 403 E 11th St 3135 Thomas Dr 403 E 11th St 330 W 23rd St Ste J 2620 Jenks Ave 3123 W 23rd St 528 W Baldwin Road 403 E 11th St 403 E 11th St 15450 Panama City Beach Pkwy 309 N Richard Jackson Blvd Ste 10 309 N Richard Jackson Blvd Ste 10 15450 Panama City Beach Pkwy 15450 Panama City Beach Pkwy 309 N Richard Jackson Blvd Ste 10 15450 Panama City Beach Pkwy 11695 Panama City Beach Pkwy 309 N Richard Jackson Blvd Ste 10 309 N Richard Jackson Blvd Ste 10 15450 Panama City Beach Pkwy

Lynn Haven Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Panama City Beach Panama City Beach Panama City Beach Panama City Beach Panama City Beach Panama City Beach Panama City Beach Panama City Beach Panama City Beach Panama City Beach Panama City Beach

23320 N State Road 235 603 E Call St 459 W Call St 603 E Call St

Brooker Starke Starke Starke

96 Willard St Ste 103 645 Brevard Ave 645 Brevard Ave 41 N Orlando Ave 5675 N Atlantic Ave Ste 108-109 495 Minutemen Cswy 5675 N Atlantic Ave Ste 108-109 1980 N Atlantic Ave Ste 905 1980 N Atlantic Ave Ste 905 30 Woodland Ave 5675 N Atlantic Ave Ste 108-109 117 N Orlando Ave 5675 N Atlantic Ave Ste 108-109 1980 N Atlantic Ave Ste 905 1980 N Atlantic Ave Ste 905

Cocoa Cocoa Cocoa Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach Cocoa Beach

State Zip

Phone

FL 32063 (904) 259-7007

FL 32444 (850) 271-8001 FL 32405 (850) 740-3100 FL 32401 (850) 767-3350 FL 32401 (850) 767-3350 FL 32401 (850) 767-3350 FL 32401 (850) 767-3350 FL 32405 (850) 481-1969 FL 32401 (850) 767-3350 FL 32405 (850) 769-3597 FL 32405 (850) 481-1969 FL 32401 (850) 785-5502 FL 32405 (850) 763-4545 FL 32405 (850) 763-4545 FL 32405 (850) 914-0550 FL 32405 (850) 769-3253 FL 32408 (850) 249-9311 FL 32401 (850) 215-3339 FL 32405 (850) 769-5580 FL 32401 (850) 763-6782 FL 32408 (850) 234-2110 FL 32405 (850) 481-1969 FL 32401 (850) 767-3350 FL 32405 (850) 640-2162 FL 32401 (850) 767-3350 FL 32405 (850) 763-5858 FL 32405 (850) 763-5858 FL 32401 (850) 767-3350 FL 32401 (850) 763-8788 FL 32405 (850) 785-8586 FL 32401 (850) 767-3350 FL 32401 (850) 763-8788 FL 32401 (850) 767-3350 FL 32408 (850) 249-9311 FL 32401 (850) 767-3350 FL 32405 (850) 769-3427 FL 32405 (850) 785-8586 FL 32405 (850) 481-1969 FL 32405 (850) 215-0128 FL 32401 (850) 767-3350 FL 32401 (850) 767-3350 FL 32413 (850) 238-3326 FL 32407 (850) 235-2299 FL 32407 (850) 235-2299 FL 32413 (850) 238-3326 FL 32413 (850) 238-3326 FL 32407 (850) 235-2299 FL 32413 (850) 238-3326 FL 32407 (850) 588-9000 FL 32407 (850) 235-2299 FL 32407 (850) 235-2299 FL 32413 (850) 238-3326

FL 32622 (352) 485-2772 FL 32091 (904) 964-2825 FL 32091 (904) 964-5152 FL 32091 (904) 964-2825

FL 32922 (321) 208-7979 FL 32922 (321) 635-8533 FL 32922 (321) 952-1625 FL 32931 (321) 799-1090 FL 32931 (321) 783-3737 FL 32931 (321) 783-7411 FL 32931 (321) 783-3737 FL 32931 (407) 784-2236 FL 32931 (407) 784-2236 FL 32931 (321) 783-7415 FL 32931 (321) 783-3737 FL 32931 (321) 783-6569 FL 32931 (321) 783-3737 FL 32931 (407) 784-2236 FL 32931 (407) 784-2236

T0e5/x2t04167:

Lists of Delta Dental dentists and benefit and eligibility information are also available on our web site: .

Page 3

Spec. Code 00 00 40 00 00 10 00 00 00 00 00 00 00 00 00 00 40 30 10 00 00 00 00 00 00 30 00 00 00 10 00 00 00 00 10 20 20 00 00 00 00 00 00 00 00 00 00 00 00 15 00 40 40 00 00 00 00 20 15 00 10 00 00 15 00 15 00 00 40 00 15 00 00 10 20 00 00

T0e5/x2t04167:

Name

Address

City

State Zip

Phone

Vevera, Keith Alvarez, Rene Baines, Edward Zakhari, Hanny Cardoso, Gary Chopra, Jayanthi Collins, Ryan Kalra, Anjay Osorio, Christopher Patel, Manoj Shah, Anand Tapper, Alexandros Abraham, Michael Ahmed, Mohammed Ahmed, Mohammed Ahmed, Mohammed Alfant, Marc Alvarez, Idaigna Arteaga, David Bacha, Elizabeth Badger, Leonard Bangash, Maryam Banoub, Sami Barrera Hagen, Maria Bell, Edward Bernal, Lissette Bielak, Paula Bielak, Paula Bielak, Paula Briceno, Hector Brody, Robert Brown Jr, Clark Bucaj, Alfons Burnes, Charles Burns Jr, Robert Carr, Beverly Carr, Elaine Chico, Jose Chico, Jose Chico, Jose De La Rosa, Andrew Diasti, Adam Dickinson, Scott Diep, Kevin Dipasquale, Anthony Doomra, Karan Doomra, Karan Dreyer, Mark Eley, Daniel Elliott, Michael Estes, Joshua Fanelli, Alfredo Fotek, Pawel Fowler, Michael Galligan, Kristina Gesicki, Jon Gillan JR, Jere Goff, Romia Greenbarg, Nancy Greer, Lucia Grider, Joseph Grigoryan, Armen Gunnell, Josh Hachmeister, Darlene Heald, Katie Hernandez, Ramon Hirsowitz, Ryan Hogan, Helena Houk, Valorie Iurcovich, Maximillian Jones, Carl Kalra, Anjay Kalra, Anjay Kaner, Keith Kapit, Arthur Kedzierski, Mark Keen, Ashley

1980 N Atlantic Ave Ste 1002 201 S Shannon Ave 140 6th Ave 401 5th Ave 2000 South Patrick Dr 257 E Eau Gallie Blvd 214 E Eau Gallie Blvd 2000 South Patrick Dr 2000 South Patrick Dr 2000 South Patrick Dr 2000 South Patrick Dr 2000 South Patrick Dr 249 Palm Bay Rd NE 2025 W New Haven Ave 3226 Lake Washington Rd #16 7827 N Wickham Rd #A 729 E Strawbridge Ave 8061 Spyglass Hill Rd Ste A-1 1371 Bedford Dr 249 Palm Bay Rd NE 2900 Lake Washington Rd Ste 3 249 Palm Bay Rd NE 7185 Murrell Rd Ste 102 3150 N Wickham Rd Ste 7 313 N Babcock St 1390 S Babcock St 2025 W New Haven Ave 3226 Lake Washington Rd #16 7827 N Wickham Rd #A 1770 N Wickham Rd 205 Palm Bay Rd NE Ste 159 2113 Sarno Rd 2419 S Babcock St 249 Palm Bay Rd NE 481 N Harbor City Blvd 1770 N Wickham Rd 205 Palm Bay Rd NE Ste 159 2025 W New Haven Ave 3226 Lake Washington Rd #16 7827 N Wickham Rd #A 249 Palm Bay Rd NE 220 N Babcock St 249 Palm Bay Rd NE 1770 N Wickham Rd 115 Capron Trl 2025 W New Haven Ave 3226 Lake Washington Rd #16 6300 N Wickham Rd Ste 121 2301 W Eau Gallie Blvd Ste 2 205 Palm Bay Rd NE Ste 159 249 Palm Bay Rd NE 1770 N Wickham Rd 205 Palm Bay Rd NE Ste 159 38 Suntree Pl Ste 1 1770 N Wickham Rd 249 Palm Bay Rd NE 249 Palm Bay Rd NE 4531 N Wickham Rd 7777 N Wickham Rd Ste 4 249 Palm Bay Rd NE 205 Palm Bay Rd NE Ste 159 249 Palm Bay Rd NE 7185 Murrell Rd Ste 102 1250 W Eau Gallie Blvd 249 Palm Bay Rd NE 1250 W Eau Gallie Blvd 249 Palm Bay Rd NE 205 Palm Bay Rd NE Ste 159 8255 N Wickham Rd Ste 103 205 Palm Bay Rd NE Ste 159 205 Palm Bay Rd NE Ste 159 1390 S Babcock St 6300 N Wickham Rd Ste 121 1770 N Wickham Rd 811 S Babcock St 2990 Business Center Blvd 249 Palm Bay Rd NE

Cocoa Beach Indialantic Indialantic Indialantic Indian Harbour Beach Indian Harbour Beach Indian Harbour Beach Indian Harbour Beach Indian Harbour Beach Indian Harbour Beach Indian Harbour Beach Indian Harbour Beach Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne

FL 32931 FL 32903 FL 32903 FL 32903 FL 32937 FL 32937 FL 32937 FL 32937 FL 32937 FL 32937 FL 32937 FL 32937 FL 32904 FL 32904 FL 32934 FL 32940 FL 32901 FL 32940 FL 32940 FL 32904 FL 32935 FL 32904 FL 32940 FL 32935 FL 32935 FL 32901 FL 32904 FL 32934 FL 32940 FL 32935 FL 32904 FL 32935 FL 32901 FL 32904 FL 32935 FL 32935 FL 32904 FL 32904 FL 32934 FL 32940 FL 32904 FL 32935 FL 32904 FL 32935 FL 32940 FL 32904 FL 32934 FL 32940 FL 32935 FL 32904 FL 32904 FL 32935 FL 32904 FL 32940 FL 32935 FL 32904 FL 32904 FL 32935 FL 32940 FL 32904 FL 32904 FL 32904 FL 32940 FL 32935 FL 32904 FL 32935 FL 32904 FL 32904 FL 32940 FL 32904 FL 32904 FL 32901 FL 32940 FL 32935 FL 32901 FL 32940 FL 32904

Lists of Delta Dental dentists and benefit and eligibility information are also available on our web site: .

(321) 236-6606 (321) 724-2757 (321) 951-1577 (321) 727-8822 (321) 773-1000 (321) 426-7816 (321) 777-6453 (321) 773-1000 (321) 773-1000 (321) 773-1000 (321) 773-1000 (321) 773-1000 (321) 482-5220 (321) 956-5664 (321) 255-1991 (321) 434-4444 (321) 984-2461 (321) 622-6255 (321) 242-2100 (321) 482-5220 (321) 259-0217 (321) 482-5220 (321) 253-9588 (321) 253-5977 (321) 259-1949 (321) 728-4546 (321) 956-5664 (321) 255-1991 (321) 434-4444 (321) 253-0606 (321) 676-4080 (321) 259-9429 (321) 956-7700 (321) 482-5220 (321) 752-0809 (321) 253-0606 (321) 676-4080 (321) 956-5664 (321) 255-1991 (321) 434-4444 (321) 482-5220 (321) 254-5521 (321) 482-5220 (321) 253-0606 (321) 259-5100 (321) 956-5664 (321) 255-1991 (321) 259-5257 (321) 622-8711 (321) 676-4080 (321) 482-5220 (321) 253-0606 (321) 676-4080 (321) 259-9511 (321) 253-0606 (321) 482-5220 (321) 482-5220 (321) 622-8804 (321) 255-6303 (321) 482-5220 (321) 676-4080 (321) 482-5220 (321) 253-9588 (321) 259-1717 (321) 482-5220 (321) 259-1717 (321) 482-5220 (321) 676-4080 (321) 242-3115 (321) 676-4080 (321) 676-4080 (321) 728-4546 (321) 259-5257 (321) 253-0606 (321) 729-0022 (321) 254-0306 (321) 482-5220

Page 4

Spec. Code 00 10 00 20 00 00 00 00 00 00 00 10 20 00 00 00 00 00 00 00 00 15 15 00 00 30 10 30 00 00 00 00 00 00 00 30 00 00 00 15 15 00 10 00 10 00 00 00 15 10 00 00 15 15 30 00 00 40 00 00 00 00 20 20 20 00 00 20 30 00 00 10 00 00 00 00 00

T0e5/x2t04167:

Name

Address

City

State Zip

Phone

Keyes, William Kim, King Klein, Nicole Kopuri, Nageswara Kretzschmar Jr, Samuel Kumar, Sadesh Kumar, Sowmya Kumar, Sowmya Lancaster, Edward Lancaster, Edward Lapointe, Michel Latham, Christopher Lockhart, Lauren Luque-Maiz, Olga Mabry, Jeffrey Maceda-Johnson, Antonio Manzur, Kasim Manzur, Kasim Mao, Song Marius, Jean Mary Matini, Joseph Mccann, John Mccann, John Mccown, Michael McDonough, Lauren Milo, Scott Milton Jr, Charles Mirda, Kristin Moini, Mahkameh Moini, Mahkameh Morris, Timothy Nagaraju, Champaka Ordehi, Licet Patel, Manoj Periu, Lie-Ying Pollock, Ray Ramos, Gerald Reichman, Lewis Reyes Vicente, Jorge Rillman, Ernest Rillman, Ernest Rodriguez, Dario Saenz, Regina Sayre Jr, Sidney Schmid, Richard Schroeder, Emily Schropp, Theodore Schumacher, Kendall Scott, Paul Sedaros, Steve Seminario, Rafael Shah, Anand Simons, Javier Sisson, Tavis Smith, Christina Spector, David Stefanczyk, Barbara Stetler, Kathy Stockton, Dale Tapper, Alexandros Thomas, Maria Umoren, Anne-Marie Valderrama, Natalia Valderrama, Natalia Vargas, Alberto Vaughn, William Watson, Braille West, Christopher Willox, Angela Youmans, Jasin Zusselman, Arnold Amundson, Melissa Atkinson, William Bangash, Maryam Brittlebank, Tirzah Bucaj, Alfons Burnes, Charles

2419 S Babcock St 1325 Pine St Ste 102 249 Palm Bay Rd NE 2555 W New Haven Ave 4301 N Wickham Rd Ste 9 2960 Bush Dr 3226 Lake Washington Rd #16 7827 N Wickham Rd #A 1390 S Babcock St 3150 N Wickham Rd Ste 7 416 S Babcock St 249 Palm Bay Rd NE 7777 N Wickham Rd Ste 4 220 N Babcock St 2261 Sarno Rd 1770 N Wickham Rd 3226 Lake Washington Rd #16 7827 N Wickham Rd #A 1390 S Babcock St 249 Palm Bay Rd NE 8095 Spyglass Hill Rd 1325 Pine St Ste 101 1360 Bedford Dr Ste 102 205 Palm Bay Rd NE Ste 159 249 Palm Bay Rd NE 3040 N Wickham Rd Ste 1 249 Palm Bay Rd NE 8061 Spyglass Hill Rd Ste A-1 2261 Sarno Rd 2261 Sarno Rd 1390 S Babcock St 2419 S Babcock St 1770 N Wickham Rd 1390 S Babcock St 6765 N Wickham Rd #105 1325 Pine St Ste 103 315 E Strawbridge Ave 205 Palm Bay Rd NE Ste 159 2261 Sarno Rd 1325 Pine St Ste 101 1360 Bedford Dr Ste 102 205 Palm Bay Rd NE Ste 159 205 Palm Bay Rd NE Ste 159 7025 N Wickham Rd Ste 105 1325 Pine St Ste 102 249 Palm Bay Rd NE 4521 N Wickham Rd Ste 101 418 E New Haven Ave 1114 Palmetto Ave 2301 W Eau Gallie Blvd # 101 2419 S Babcock St 3150 N Wickham Rd Ste 7 1250 W Eau Gallie Blvd 1250 W Eau Gallie Blvd 205 Palm Bay Rd NE Ste 159 7777 N Wickham Rd Ste 4 7777 N Wickham Rd Ste 4 2755 N Wickham Rd Ste 102 2900 Lake Washington Rd Ste 3 3150 N Wickham Rd Ste 7 1770 N Wickham Rd 249 Palm Bay Rd NE 1390 S Babcock St 903 Jordan Blass Dr Ste 102 1325 Pine St Ste 103 2113 Sarno Rd 402 N Babcock St Ste 103 205 Palm Bay Rd NE Ste 159 2301 W Eau Gallie Blvd Ste 2 5545 N Wickham Rd 205 Palm Bay Rd NE Ste 159 775 E Merritt Island Cswy #115 800 E Merritt Island Cswy Ste 105 800 E Merritt Island Cswy Ste 105 800 E Merritt Island Cswy Ste 105 190 S Sykes Creek Pkwy Ste 2 800 E Merritt Island Cswy Ste 105

Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Melbourne Merritt Island Merritt Island Merritt Island Merritt Island Merritt Island Merritt Island

FL 32901 FL 32901 FL 32904 FL 32904 FL 32935 FL 32935 FL 32934 FL 32940 FL 32901 FL 32935 FL 32901 FL 32904 FL 32940 FL 32935 FL 32935 FL 32935 FL 32934 FL 32940 FL 32901 FL 32904 FL 32940 FL 32901 FL 32940 FL 32904 FL 32904 FL 32935 FL 32904 FL 32940 FL 32935 FL 32935 FL 32901 FL 32901 FL 32935 FL 32901 FL 32940 FL 32901 FL 32901 FL 32904 FL 32935 FL 32901 FL 32940 FL 32904 FL 32904 FL 32940 FL 32901 FL 32904 FL 32935 FL 32901 FL 32901 FL 32935 FL 32901 FL 32935 FL 32935 FL 32935 FL 32904 FL 32940 FL 32940 FL 32935 FL 32935 FL 32935 FL 32935 FL 32904 FL 32901 FL 32940 FL 32901 FL 32935 FL 32935 FL 32904 FL 32935 FL 32940 FL 32904 FL 32952 FL 32952 FL 32952 FL 32952 FL 32952 FL 32952

Lists of Delta Dental dentists and benefit and eligibility information are also available on our web site: .

(321) 956-7700 (321) 725-5377 (321) 482-5220 (321) 728-9999 (321) 242-2236 (321) 956-0999 (321) 255-1991 (321) 434-4444 (321) 728-4546 (321) 253-5977 (321) 951-1360 (321) 482-5220 (321) 255-6303 (321) 254-5521 (321) 255-0601 (321) 253-0606 (321) 255-1991 (321) 434-4444 (321) 728-4546 (321) 482-5220 (321) 757-5074 (321) 984-0034 (321) 242-7550 (321) 676-4080 (321) 482-5220 (321) 242-2730 (321) 482-5220 (321) 622-6255 (321) 254-6322 (321) 255-0601 (321) 728-4546 (321) 956-7700 (321) 253-0606 (321) 728-4546 (321) 622-8960 (321) 724-4520 (321) 956-7111 (321) 676-4080 (321) 254-6322 (321) 984-0034 (321) 242-7550 (321) 676-4080 (321) 676-4080 (321) 253-1616 (321) 725-5377 (321) 482-5220 (321) 255-2700 (321) 722-3337 (320) 722-0550 (321) 610-7868 (321) 956-7700 (321) 253-5977 (321) 259-1717 (321) 259-1717 (321) 676-4080 (321) 255-6303 (321) 255-6303 (321) 255-9600 (321) 259-0217 (321) 253-5977 (321) 253-0606 (321) 482-5220 (321) 728-4546 (321) 544-4127 (321) 724-4520 (321) 259-9429 (321) 259-2161 (321) 676-4080 (321) 622-8711 (321) 474-9518 (321) 676-4080 (321) 453-7272 (321) 453-8882 (321) 453-8882 (321) 453-8882 (321) 452-8334 (321) 453-8882

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