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General NPI Number Information
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NPI Number | 1700352192
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Entity Type | Organization
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Legal Business Name | FARINA ORTHODONTIC SPECIALISTS
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 2370 BRUCE B DOWNS BLVD STE A
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-9214
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Country | US
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Telephone | 813-972-2929
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Fax | 813-994-6464
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Provider Business Mailing Address
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Address Line | 2370 BRUCE B DOWNS BLVD STE A
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-9214
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Country | US
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Telephone | 813-972-2929
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Fax | 813-994-6464
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK FARINA
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Credential | DMD
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Telephone | 813-972-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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