| Kidzone Dentistry Pa | |
|
13127 Kings Lake Dr Unit 101 Gibsonton FL 33534-3958 | |
| (813) 677-3047 | |
| (813) 284-7959 |
| Full Name | Kidzone Dentistry Pa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 13127 Kings Lake Dr Unit 101, Gibsonton, Florida |
| Authorized Official Name and Position | Mounika Falemban (OWNER) |
| Authorized Official Contact | 8134084634 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidzone Dentistry Pa 6815 Scenic Dr Apollo Beach FL 33572-1543 Ph: (813) 408-4634 | Kidzone Dentistry Pa 13127 Kings Lake Dr Unit 101 Gibsonton FL 33534-3958 Ph: (813) 677-3047 |
| NPI Number | 1134531270 |
|---|---|
| Provider Enumeration Date | 05/23/2014 |
| Last Update Date | 06/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134531270 | NPI | - | NPPES |
| 007161100 | Medicaid | FL | |
| 1144472713 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN18289 (Florida) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | DN18289 (Florida) | Primary |
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