Organization
LITHIA PINECREST SMILES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CROUCH (VP)
(321) 872-8820
Entity
Organization
Contact information
Practice address
716 S OAKWOOD AVE, BRANDON, FL 33511-6124
(813) 285-4084
(813) 285-4951
Mailing address
716 S OAKWOOD AVE, BRANDON, FL 33511-6124
(813) 285-4084
(813) 285-4951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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