# HOLLYWOOD SMILE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649641077
- **Authorized official:** LESLIE ENDRIS (OPERATIONS MANAGER)
- **Authorized official phone:** (727) 202-1053

## Contact information

- **Practice address:** 32919 US HIGHWAY 19 N, PALM HARBOR, FL 34684-3121
- **Practice address phone:** (727) 202-1054
- **Practice address fax:** (844) 727-9580
- **Mailing address:** 2702 TAMPA RD, PALM HARBOR, FL 34684-3311
- **Mailing address phone:** (727) 781-2424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 13292 | FL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 13292 | FL | Yes |

## Other

- **Enumeration date:** 10/12/2015
- **Last updated:** 10/12/2015