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General NPI Number Information
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NPI Number | 1932456571
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Entity Type | Organization
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Legal Business Name | CORNERSTONE DENTAL
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 12/24/2019
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Provider Practice Location Address
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Address Line | 4009 TAMPA RD SUITE 6
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City | OLDSMAR
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State | FL
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Zip | 34677-3206
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Country | US
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Telephone | 813-448-7828
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Fax |
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Provider Business Mailing Address
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Address Line | 4009 TAMPA RD SUITE 6
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City | OLDSMAR
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State | FL
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Zip | 34677-3206
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Country | US
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Telephone | 813-448-7828
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN AUBREY FRANKLIN
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Credential | DMD
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Telephone | 813-448-7828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN00186
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN18577
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN 14080
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | F11975
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License Number State | FL
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