A Family Dentist PA
Dentist, General Practice in New Port Richey, FL. Organization (NPI-2).
NPI number1194119255
StatusActive
Last updated in NPPESMar 26, 2015
Details
- NPI
- 1194119255
- Entity type
- Organization (NPI-2)
- Legal business name
- A Family Dentist PA
- Organization subpart
- No
- Enumeration date
- Mar 26, 2015
- Last updated
- Mar 26, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DN18780 | FL | Yes |
Other names
- A Family Dentist (Doing Business As)
Practice location
5153 Marine PkwyNew Port Richey, FL 34652
Phone 727-645-6932 · Fax 727-807-3397
Mailing address
5153 Marine PkwyNew Port Richey, FL 34652
Phone 727-645-6932 · Fax 727-807-3397
Authorized official
Cristen Marie Mendoza
Owner/Dentist
7278087886
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