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General NPI Number Information
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NPI Number | 1174135412
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Entity Type | Organization
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Legal Business Name | EARL P SANTOS DMD PA
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 2535 LANDMARK DR STE 104
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City | CLEARWATER
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State | FL
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Zip | 33761-3930
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Country | US
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Telephone | 727-791-1450
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Fax |
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Provider Business Mailing Address
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Address Line | 1393 KITTERY CT
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-2623
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Country | US
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Telephone | 412-513-5494
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | EARL SANTOS
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Credential | DMD
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Telephone | 412-513-5494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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