Organization · NPI-2

Affiliated Dental Specialist Pl

Dentist, General Practice · Tampa, FL

NPI number1215457767
StatusActive
Last updated in NPPESOct 10, 2017

Details

NPI
1215457767
Entity type
Organization (NPI-2)
Legal business name
Affiliated Dental Specialist Pl
Organization subpart
No
Enumeration date
Jun 26, 2017
Last updated
Oct 10, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeDN9319FLYes

Other names

  • Dental Specialists Of Florida (Doing Business As)

Practice location

17401 Commerce Park Blvd Ste 101
Tampa, FL 33647-3507

Phone 813-915-6097 · Fax 813-615-0750

Mailing address

6311 4th St N
St Petersburg, FL 33702-7511

Phone 727-522-5599 · Fax 727-526-1702

Authorized official

Alan Shoopak
Doctor
7275225599

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