Organization
KIDZONE DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOUNIKA FALEMBAN BDS, MDS (OWNER)
(813) 408-4634
Entity
Organization
Contact information
Practice address
13127 KINGS LAKE DR UNIT 101, GIBSONTON, FL 33534-3958
(813) 677-3047
(813) 284-7959
Mailing address
6815 SCENIC DR, APOLLO BEACH, FL 33572-1543
(813) 408-4634
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN18289
FL
1223P0221X
Pediatric Dentistry
Primary
DN18289
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007161100
—
FL
01
—
1144472713
NPI
FL
Enumeration date
05/23/2014
Last updated
06/30/2020
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