Organization
DENTISTS OF DAVENPORT, PA
Active
Other names
DENTISTS OF DAVENPORT
Organization subpart
No
Provider details
NPI number
Authorized official
OMEIR TARIQ ANSARI DDS (OWNER)
(863) 812-4570
Entity
Organization
Contact information
Practice address
2122 TRIGLIA WAY, DAVENPORT, FL 33896
(863) 812-4570
(863) 812-4219
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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