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122 Harbor Village Ln Apollo Beach FL 33572-3402 | |
| (813) 298-3719 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 122 Harbor Village Ln, Apollo Beach, Florida |
| Authorized Official Name and Position | Casey Lynn (OWNER) |
| Authorized Official Contact | 8122983719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2812 Commonwealth Ave Valrico FL 33594-4784 Ph: (813) 298-3719 | 122 Harbor Village Ln Apollo Beach FL 33572-3402 Ph: (813) 298-3719 |
| NPI Number | 1568953867 |
|---|---|
| Provider Enumeration Date | 05/22/2018 |
| Last Update Date | 05/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568953867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN21339 (Florida) | Primary |
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