Organization · NPI-2

Aesthetic Dentistry Of New Tampa

Dentist, General Practice · Tampa, FL

NPI number1710099353
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1710099353
Entity type
Organization (NPI-2)
Legal business name
Aesthetic Dentistry Of New Tampa
Organization subpart
No
Enumeration date
Aug 31, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeDN14694FLYes

Practice location

8709 Hunters Green Dr
Suite 102
Tampa, FL 33647-2309

Phone 813-991-1088 · Fax 813-991-4817

Mailing address

8709 Hunters Green Dr
Suite 102
Tampa, FL 33647-2309

Phone 813-991-1088 · Fax 813-991-4817

Authorized official

Fardin Zare
Owner
8139911088

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