| Fishhawk Modern Dentistry | |
|
16509 Fishhawk Blvd Lithia FL 33547-3835 | |
| (813) 563-8108 | |
| Not Available |
| Full Name | Fishhawk Modern Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 16509 Fishhawk Blvd, Lithia, Florida |
| Authorized Official Name and Position | Katie L Mccann Lee (OWNER/GP) |
| Authorized Official Contact | 8135638108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fishhawk Modern Dentistry Po Box 920050 Dallas TX 75392-0050 Ph: () - | Fishhawk Modern Dentistry 16509 Fishhawk Blvd Lithia FL 33547-3835 Ph: (813) 563-8108 |
| NPI Number | 1730726506 |
|---|---|
| Provider Enumeration Date | 11/29/2019 |
| Last Update Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730726506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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