| Pediatric Dentistry Of Brandon | |
|
3413 S Kings Ave Ste 200 Brandon FL 33511-7780 | |
| (813) 685-0804 | |
| (813) 681-7213 |
| Full Name | Pediatric Dentistry Of Brandon |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3413 S Kings Ave Ste 200, Brandon, Florida |
| Authorized Official Name and Position | Nicole Caride (CREDENTIALING MGR) |
| Authorized Official Contact | 7277842721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Brandon 2300 Lakeview Pkwy Ste 250 Alpharetta GA 30009-3954 Ph: (470) 207-3264 | Pediatric Dentistry Of Brandon 3413 S Kings Ave Ste 200 Brandon FL 33511-7780 Ph: (813) 685-0804 |
| NPI Number | 1750056859 |
|---|---|
| Provider Enumeration Date | 08/11/2021 |
| Last Update Date | 08/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750056859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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