MEDICARE: CHILDREN AND TEEN DENTAL GROUP OF FLORIDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1223P0221X	Pediatric Dentistry
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
3	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1518749944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN AND TEEN DENTAL GROUP OF FLORIDA

Provider Business Mailing Address
First Line	:	2300 LAKEVIEW PKWY STE 250
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-3954
Country	:	US
Telephone Number	:	727-784-2721
Fax Number	:

Provider Business Practice Location Address
First Line	:	2939 ALT 19
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1928
Country	:	US
Telephone Number	:	727-785-6521
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BRIAN SMITH
Credential	:
Telephone Number	:	470-207-3264

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	01/21/2025

Similar Medicare Providers

1982657672 — DR. LOUISE OYCO SANTOS MD
Practice Location Address:

2939 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-785-2298
Practice Fax: 813-635-7944

1215270111 — LUPITA CATRINA GALLARDO M.D.
Practice Location Address:

2931 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-785-2298
Practice Fax: 813-635-7944

1821422783 — DR. MATTHEW R. IRVIN M.D.
Practice Location Address:

2939 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-785-2295
Practice Fax: 813-635-7944

1225495526 — MRS. KELLY MARIE MULLIKIN PA-C
Practice Location Address:

2939 ALT 19 # MS 702
PALM HARBOR, FL
34683-1928

Practice Phone: 727-786-5058
Practice Fax: 813-635-2639

1770153579 — BAYCARE MEDICAL GROUP INC
Practice Location Address:

2939 ALT 19
PALM HARBOR, FL
34683-1928

Practice Phone: 727-547-8425
Practice Fax: 813-635-2699

1952032120 — DR. LINDSEY ANN CRNALIC DMD
Practice Location Address:

2939 PALM HARBOR BLVD
PALM HARBOR, FL
34683-1928

Practice Phone: 727-348-0830
Practice Fax:

Directions to “CHILDREN AND TEEN DENTAL GROUP OF FLORIDA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.