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General NPI Number Information
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NPI Number | 1235475419
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Entity Type | Organization
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Legal Business Name | FLORIDA ORTHODONTIC ASSOCIATES,LLC
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Dates
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Enumeration Date | 12/17/2012
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 1433 COURT ST
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City | CLEARWATER
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State | FL
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Zip | 33756-6146
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Country | US
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Telephone | 727-442-6098
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Fax | 727-442-0510
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Provider Business Mailing Address
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Address Line | 1433 COURT ST
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City | CLEARWATER
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State | FL
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Zip | 33756-6146
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Country | US
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Telephone | 727-442-6098
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Fax | 727-442-0510
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERNEST HOWARD MCDOWELL
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Credential | D.M.D
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Telephone | 727-442-6098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN10571
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License Number State | FL
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