| Pediatric Dentistry Of New Tampa | |
|
5326 Primrose Lake Cir Tampa FL 33647-3589 | |
| (813) 374-0388 | |
| (813) 374-0390 |
| Full Name | Pediatric Dentistry Of New Tampa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5326 Primrose Lake Cir, Tampa, Florida |
| Authorized Official Name and Position | Marta Milagros Rivera (PRESIDENT/OWNER) |
| Authorized Official Contact | 8133740388 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of New Tampa 5326 Primrose Lake Cir Tampa FL 33647-3589 Ph: (813) 374-0388 | Pediatric Dentistry Of New Tampa 5326 Primrose Lake Cir Tampa FL 33647-3589 Ph: (813) 374-0388 |
| NPI Number | 1891128773 |
|---|---|
| Provider Enumeration Date | 08/15/2013 |
| Last Update Date | 08/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891128773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN14483 (Florida) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | DN19520 (Florida) | Secondary |
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