Individual
JESSICA OLIVEIRA SOARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8863 CAMERON CREST DR, TAMPA, FL 33626-4732
(813) 295-5210
Mailing address
8863 CAMERON CREST DR, TAMPA, FL 33626-4732
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN28008
FL
390200000X
Student in an Organized Health Care Education/Training Program
DRPM2268
FL
Other
Enumeration date
03/12/2021
Last updated
07/19/2023
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