Organization
TABARES DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YADNAY TABARES DDS (PRESIDENT)
(615) 477-4047
Entity
Organization
Contact information
Practice address
18964 N DALE MABRY HWY, SUITE # 101, LUTZ, FL 33548-4913
(615) 477-4047
Mailing address
18964 N DALE MABRY HWY, SUITE # 101, LUTZ, FL 33548-4913
(615) 477-4047
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN20019
FL
Other
Enumeration date
11/02/2016
Last updated
11/02/2016
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