Organization · NPI-2

Advanced Dental Care Of Citrus Park P.A.

Dentist · Tampa, FL

NPI number1669504072
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1669504072
Entity type
Organization (NPI-2)
Legal business name
Advanced Dental Care Of Citrus Park P.A.
Organization subpart
No
Enumeration date
Mar 12, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist––Yes

Practice location

7620 Gunn Hwy
Tampa, FL 33625-3144

Phone 813-920-4201

Mailing address

7620 Gunn Hwy
Tampa, FL 33625-3144

Authorized official

Mike Cole
Insurance Director
7277261611

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