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General NPI Number Information
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NPI Number | 1285127084
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Entity Type | Individual
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Provider Name | DANA NICOLE DELOSA DMD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 11119 HEARTH RD
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City | SPRING HILL
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State | FL
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Zip | 34608-3727
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Country | US
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Telephone | 352-683-2283
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Fax |
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Provider Business Mailing Address
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Address Line | 8196 VIA DI VENETO
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City | BOCA RATON
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State | FL
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Zip | 33496-1974
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Country | US
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Telephone | 954-304-3883
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN23367
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License Number State | FL
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