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General NPI Number Information
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NPI Number | 1477702140
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Entity Type | Organization
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Legal Business Name | SUN DENTAL INC
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 1528 LAND O LAKES BLVD SUITE 101
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City | LUTZ
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State | FL
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Zip | 33549-2903
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Country | US
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Telephone | 813-948-0404
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Fax | 813-948-4484
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Provider Business Mailing Address
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Address Line | 1528 LAND O LAKES BLVD SUITE 101
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City | LUTZ
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State | FL
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Zip | 33549-2903
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Country | US
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Telephone | 813-948-0404
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Fax | 813-948-4484
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. PARESH JAYANT PARIKSHAK
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Credential | DDS
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Telephone | 727-844-5520
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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 | DN14074
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN13340
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License Number State | FL
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