MEDICARE: FLORIDA PEDIATRIC DENTAL ASSOCIATES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1427615608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA PEDIATRIC DENTAL ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	1433 COURT ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-6146
Country	:	US
Telephone Number	:	727-442-6098
Fax Number	:

Provider Business Practice Location Address
First Line	:	1433 COURT ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-6146
Country	:	US
Telephone Number	:	727-442-6098
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ERNEST H MCDOWELL
Credential	:	DMD
Telephone Number	:	727-442-6098

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	05/23/2019

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