| Park Boulevard Family Dentistry | |
|
4326 Park Blvd N Ste A Pinellas Park FL 33781-3538 | |
| (727) 291-0220 | |
| Not Available |
| Full Name | Park Boulevard Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 4326 Park Blvd N Ste A, Pinellas Park, Florida |
| Authorized Official Name and Position | Brianne Leigh Wade (OWNER/PRESIDENT/DENTIST) |
| Authorized Official Contact | 8132446045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Boulevard Family Dentistry 4326 Park Blvd N Ste A Pinellas Park FL 33781-3538 Ph: (727) 291-0220 | Park Boulevard Family Dentistry 4326 Park Blvd N Ste A Pinellas Park FL 33781-3538 Ph: (727) 291-0220 |
| NPI Number | 1578170684 |
|---|---|
| Provider Enumeration Date | 09/24/2020 |
| Last Update Date | 09/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578170684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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