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General NPI Number Information
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NPI Number | 1265412027
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Entity Type | Individual
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Provider Name | RICHARD KOLANDA DDS, RPH
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1301 BEACH DR.
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City | ST. PETERSBURG
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State | FL
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Zip | 33701
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Country | US
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Telephone | 727-502-1591
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Fax |
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Provider Business Mailing Address
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Address Line | 8706 28TH STREET CIR E
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City | PARRISH
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State | FL
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Zip | 34219-8300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS035092
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License Number State | PA
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