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Organization
YOUNG SMILES PEDIATRIC DENTISTRY & SPA P.A
Active
Organization
YOUNG SMILES PEDIATRIC DENTISTRY & SPA P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERA YOUNG DDS (PEDODONTIST)
(813) 829-9075
Entity
Organization
Contact information
Practice address
13131 KINGS LAKE DR, SUITE # 104, GIBSONTON, FL 33534-3959
(813) 829-9075
(813) 236-9006
Mailing address
PO BOX 486, LITHIA, FL 33547-0486
(813) 829-9075
(813) 236-9007
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070219600
—
FL
Enumeration date
11/13/2013
Last updated
11/13/2013
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