| Advanced Dental Associates | |
|
15303 Amberly Dr Ste D Tampa FL 33647-2308 | |
| (813) 972-9077 | |
| Not Available |
| Full Name | Advanced Dental Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 15303 Amberly Dr Ste D, Tampa, Florida |
| Authorized Official Name and Position | Justin Elikofer (DENTIST/OWNER) |
| Authorized Official Contact | 8125681195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Associates 15303 Amberly Dr Ste D Tampa FL 33647-2308 Ph: () - | Advanced Dental Associates 15303 Amberly Dr Ste D Tampa FL 33647-2308 Ph: (813) 972-9077 |
| NPI Number | 1255081378 |
|---|---|
| Provider Enumeration Date | 03/24/2022 |
| Last Update Date | 05/11/2022 |
| Medicare PECOS PAC ID | 7416338629 |
|---|---|
| Medicare Enrollment ID | O20220719003823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255081378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Justin Elikofer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669929600 PECOS PAC ID: 5193103844 Enrollment ID: I20220719003843 |
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