| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 24795 State Road 54, Lutz, Florida |
| Authorized Official Name and Position | Isis El Ghannam (OWNER) |
| Authorized Official Contact | 7867161589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8048 Praise Dr Tampa FL 33625-3744 Ph: () - | 24795 State Road 54 Lutz FL 33559 Ph: (813) 733-0007 |
| NPI Number | 1154191153 |
|---|---|
| Provider Enumeration Date | 01/02/2024 |
| Last Update Date | 01/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154191153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
Hawley & Hawley Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21752 State Road 54, Lutz, FL 33549 Phone: 813-948-2483 Fax: 813-948-3297 | |
William J Geyer Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 148 Whitaker Rd, Lutz, FL 33549 Phone: 813-949-3211 Fax: 813-949-2714 | |
Lutz Endodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18944 N Dale Mabry Hwy, Lutz, FL 33548 Phone: 561-827-3009 | |
Tabares Dental Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18964 N Dale Mabry Hwy, Suite # 101, Lutz, FL 33548 Phone: 615-477-4047 |