Healthcare Provider Details

I. General information

NPI: 1982863023
Provider Name (Legal Business Name): ARNOLD & PARKINSON DENTISTRY PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10465 GIBSONTON DR
RIVERVIEW FL
33578-5427
US

IV. Provider business mailing address

10465 GIBSONTON DR
RIVERVIEW FL
33578-5427
US

V. Phone/Fax

Practice location:
  • Phone: 813-677-7800
  • Fax: 813-677-6042
Mailing address:
  • Phone: 813-677-7800
  • Fax: 813-677-6042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN14255
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN17006
License Number StateFL

VIII. Authorized Official

Name: NADIA N MITCHELL
Title or Position: OFFICE MANAGER
Credential:
Phone: 813-677-7800