Healthcare Provider Details

I. General information

NPI: 1871654269
Provider Name (Legal Business Name): KEVIN AUBREY FRANKLIN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4009 TAMPA RD SUITE 6
OLDSMAR FL
34677-3206
US

IV. Provider business mailing address

3110 W SAN MIGUEL ST
TAMPA FL
33629-5947
US

V. Phone/Fax

Practice location:
  • Phone: 813-448-7828
  • Fax:
Mailing address:
  • Phone: 813-448-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN11975
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: