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General NPI Number Information
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NPI Number | 1487285276
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Entity Type | Organization
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Legal Business Name | TALLY DENTAL, PA
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 2418 MILLCREEK LN # 3
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4368
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Country | US
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Telephone | 850-727-5773
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Fax |
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Provider Business Mailing Address
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Address Line | 3425 BANNERMAN RD STE 105-138
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City | TALLAHASSEE
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State | FL
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Zip | 32312-7062
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Country | US
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Telephone | 850-727-5773
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ROMELIO R ABREU
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Credential | DMD
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Telephone | 850-727-5773
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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 |
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License Number State |
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