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Organization
ENDODONTIC SPECIALISTS
Active
Organization
ENDODONTIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORY SELLECK (PRACTICE MANAGER)
(813) 964-8833
Entity
Organization
Contact information
Practice address
3670 HENDERSON BLVD STE B, TAMPA, FL 33609-4515
(813) 871-5900
(813) 875-7701
Mailing address
5111 EHRLICH RD STE 130, TAMPA, FL 33624-2074
(813) 964-8833
(813) 964-8883
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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