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Organization
DEEP ROOTS DENTAL AND FACIAL ASETHETICS LLC
Active
Organization
DEEP ROOTS DENTAL AND FACIAL ASETHETICS LLC
Active
Other names
Deep Roots Dental And Facial Asethetics LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARNIE CHALL BAUER DMD (OWNER)
(813) 839-2273
Entity
Organization
Contact information
Practice address
3013 ALLEGRA WAY, LUTZ, FL 33559-6997
(813) 839-2273
Mailing address
4509 W CULBREATH AVE, TAMPA, FL 33609-4205
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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