Healthcare Provider Details
I. General information
NPI: 1912231663
Provider Name (Legal Business Name): WEST COAST DENTAL PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2009
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4104 LITTLE RD
NEW PORT RICHEY FL
34655-1721
US
IV. Provider business mailing address
4104 LITTLE RD
NEW PORT RICHEY FL
34655-1721
US
V. Phone/Fax
- Phone: 727-376-2666
- Fax: 727-375-2577
- Phone: 727-376-2666
- Fax: 727-375-2577
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DN17419 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DN15456 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DN15964 |
| License Number State | FL |
VIII. Authorized Official
Name: MRS.
MILI
PATEL
Title or Position: OWNER/DENTIST
Credential: D.M.D.
Phone: 727-376-2666