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General NPI Number Information
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NPI Number | 1225920853
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Entity Type | Organization
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Legal Business Name | BOULEVARD DENTAL CITRUS PARK, LLC
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 8325 GUNN HWY
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City | TAMPA
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State | FL
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Zip | 33626-1608
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Country | US
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Telephone | 813-413-4982
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Fax |
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Provider Business Mailing Address
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Address Line | 8325 GUNN HWY
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City | TAMPA
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State | FL
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Zip | 33626-1608
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Country | US
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Telephone | 813-413-4982
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRIS WUJICK
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Credential | DMD
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Telephone | 352-262-5220
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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 |
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License Number State |
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