Healthcare Provider Details

I. General information

NPI: 1104637909
Provider Name (Legal Business Name): WCDAK ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 MARYWEATHER LN STE 101
WESLEY CHAPEL FL
33544-7779
US

IV. Provider business mailing address

6415 SHELDON RD
TAMPA FL
33615-3102
US

V. Phone/Fax

Practice location:
  • Phone: 813-880-0100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY CHANDLER
Title or Position: MANAGER
Credential:
Phone: 863-644-0430