Periodontal Associates Of Tampa Bay, P.a. | |
5208 E Fowler Ave Ste F Temple Terrace FL 33617-2152 | |
(813) 988-1103 | |
(813) 985-1524 |
Full Name | Periodontal Associates Of Tampa Bay, P.a. |
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Speciality | Dentist - Periodontics |
Location | 5208 E Fowler Ave Ste F, Temple Terrace, Florida |
Authorized Official Name and Position | Brian Todd Vanaelst (PERIODONTIST) |
Authorized Official Contact | 8139881103 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Periodontal Associates Of Tampa Bay, P.a. 5208 E Fowler Ave Ste F Temple Terrace FL 33617-2152 Ph: (813) 988-1103 | Periodontal Associates Of Tampa Bay, P.a. 5208 E Fowler Ave Ste F Temple Terrace FL 33617-2152 Ph: (813) 988-1103 |
NPI Number | 1053606178 |
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Provider Enumeration Date | 06/16/2011 |
Last Update Date | 06/16/2011 |
Identifier | Type | State | Issuer |
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1053606178 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0300X | Dentist - Periodontics | DN16867 (Florida) | Primary |
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