Healthcare Provider Details

I. General information

NPI: 1265117766
Provider Name (Legal Business Name): CAROLINE ALLBERT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 113TH ST
SEMINOLE FL
33772-2800
US

IV. Provider business mailing address

2098 SEMINOLE BLVD APT 3404
LARGO FL
33778-1724
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7800
  • Fax:
Mailing address:
  • Phone: 704-208-7730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDRPM2620
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: