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Coast Dental P.A.

Dentist in Riverview, FL. Organization (NPI-2).

NPI number1487220729
StatusActive
Last updated in NPPESMay 27, 2021

Details

NPI
1487220729
Entity type
Organization (NPI-2)
Legal business name
Coast Dental P.A.
Organization subpart
Yes
Enumeration date
May 27, 2021
Certification date
May 27, 2021
Last updated
May 27, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist––Yes

Other names

  • Coast Dental-Riverview (Doing Business As)

Practice location

10625 Big Bend Rd
Riverview, FL 33579-7176

Phone 813-549-0931 · Fax 813-549-0932

Mailing address

5706 Benjamin Center Dr Ste 103
Tampa, FL 33634-5262

Phone 813-288-1999

Authorized official

Melody Rivera
Credentialing Manager
8133507166

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