# COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HEARTLAND DENTAL
- **Other names:** St. Petersburg Oral Surgery
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962162883
- **Legal business name:** HEARTLAND DENTAL
- **Authorized official:** HILLARY THULL (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-8946

## Contact information

- **Practice address:** 7135 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33702-5819
- **Practice address phone:** (727) 525-5455
- **Mailing address:** 7135 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33702-5819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | NULL | — |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2021
- **Last updated:** 07/20/2022