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General NPI Number Information
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NPI Number | 1366228488
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Entity Type | Organization
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Legal Business Name | DENTAL EEXPERTS OF FLORIDA
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 1601 RICKENBACKER DR
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5332
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Country | US
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Telephone | 813-943-1790
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Fax |
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Provider Business Mailing Address
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Address Line | 8108 RIVER MONT WAY
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-7921
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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 | MANAGER
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Name | HAMED ELJABALI
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Credential | DMD
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Telephone | 813-943-1790
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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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