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General NPI Number Information
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NPI Number | 1013067503
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Entity Type | Organization
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Legal Business Name | GROOMES DENTAL P.A.
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 37149 FLORIDA AVE
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City | DADE CITY
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State | FL
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Zip | 33525-4625
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Country | US
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Telephone | 352-567-2997
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Fax |
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Provider Business Mailing Address
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Address Line | 37149 FLORIDA AVE
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City | DADE CITY
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State | FL
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Zip | 33525-4625
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Country | US
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Telephone | 352-567-2997
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Fax | 352-567-3284
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Authorized Official
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Title or Position | OWNER /DOCTOR
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Name | DR. REBECCA GROOMES
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Credential |
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Telephone | 352-567-2997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15978
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License Number State | FL
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