Trae Pappas DDS P.A.
Clinic/Center, Dental in Crestview, FL. Organization (NPI-2).
NPI number1336748946
StatusActive
Last updated in NPPESOct 23, 2020
Details
- NPI
- 1336748946
- Entity type
- Organization (NPI-2)
- Legal business name
- Trae Pappas DDS P.A.
- Organization subpart
- No
- Enumeration date
- Oct 23, 2020
- Certification date
- Oct 23, 2020
- Last updated
- Oct 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
5170 S Ferdon BlvdCrestview, FL 32536-9258
Phone 850-689-2332
Mailing address
5170 S Ferdon BlvdCrestview, FL 32536-9258
Phone 850-689-2332
Authorized official
Trae Harbeson Pappas
Owner/President
8506858461
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All 5 Dental Clinic/Center providers in Crestview · All 1,137 providers in Crestview
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