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General NPI Number Information
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NPI Number | 1881801488
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Entity Type | Organization
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Legal Business Name | AESTHETIC DENTISTRY OF PALM CITY
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2812 SW MAPP RD
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City | PALM CITY
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State | FL
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Zip | 34990-2722
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Country | US
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Telephone | 772-283-8350
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Fax | 772-220-8750
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Provider Business Mailing Address
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Address Line | 2812 SW MAPP RD
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City | PALM CITY
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State | FL
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Zip | 34990-2722
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Country | US
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Telephone | 772-283-8350
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Fax | 772-220-8750
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS A GALINIS
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Credential |
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Telephone | 772-283-8350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0014301
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License Number State | FL
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