Individual
DR. JUSTIN VICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6526 GUNN HWY, TAMPA, FL 33625-4022
(813) 374-2290
Mailing address
6526 GUNN HWY, TAMPA, FL 33625-4022
(616) 540-2584
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN25811
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/23/2015
Last updated
06/20/2021
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