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General NPI Number Information
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NPI Number | 1639478142
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Entity Type | Individual
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Provider Name | RICARDO SANPEDRO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 01/21/2013
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Provider Practice Location Address
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Address Line | 19115 CROOKED LN
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City | LUTZ
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State | FL
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Zip | 33548-4413
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Country | US
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Telephone | 813-349-8456
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Fax | 813-425-0098
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Provider Business Mailing Address
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Address Line | 19115 CROOKED LN
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City | LUTZ
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State | FL
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Zip | 33548-4413
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Country | US
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Telephone | 813-349-8456
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Fax | 813-425-0098
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN9718
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License Number State | FL
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