Organization
FAMILY AND COSMETIC DENTISTRY OF TEMPLE TERRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS VIVIANA CABRERA (OFFICE MANAGER)
(813) 988-2729
Entity
Organization
Contact information
Practice address
224 BULLARD PKWY, TEMPLE TERRACE, FL 33617-5512
(813) 988-2729
(813) 988-8729
Mailing address
224 BULLARD PKWY, TEMPLE TERRACE, FL 33617-5512
(813) 988-2729
(813) 988-8729
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
DN-0014538
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071698700
—
FL
Enumeration date
03/31/2017
Last updated
03/31/2017
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