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General NPI Number Information
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NPI Number | 1497132559
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL CARE SPECIALISTS INC
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 13736 LITTLE RD
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City | HUDSON
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State | FL
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Zip | 34667-8024
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Country | US
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Telephone | 727-869-3886
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Fax |
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Provider Business Mailing Address
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Address Line | 13736 LITTLE RD
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City | HUDSON
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State | FL
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Zip | 34667-8024
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Country | US
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Telephone | 727-869-3886
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAIME ESTRADA
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Credential | DDS
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Telephone | 727-869-3886
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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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