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General NPI Number Information
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NPI Number | 1821830209
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Entity Type | Organization
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Legal Business Name | LAF DENTAL STUDIO INC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 2708 W VIRGINIA AVE
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City | TAMPA
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State | FL
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Zip | 33607-6380
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Country | US
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Telephone | 305-763-5346
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Fax |
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Provider Business Mailing Address
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Address Line | 2708 W VIRGINIA AVE
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City | TAMPA
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State | FL
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Zip | 33607-6380
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Country | US
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Telephone | 305-763-5346
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST -OWNER
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Name | FRANK PEREZ
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Credential | DMD
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Telephone | 305-763-5346
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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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