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Organization
COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA
Active
Organization
COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA
Active
Parent organization
HEARTLAND DENTAL
Other names
St. Petersburg Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEARTLAND DENTAL
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
7135 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33702-5819
(727) 525-5455
Mailing address
7135 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33702-5819
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
NULL
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/20/2021
Last updated
07/20/2022
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