Organization
IMAGINE ORTHODONTIC STUDIO PLLC
Active
Organization
IMAGINE ORTHODONTIC STUDIO PLLC
Active
Other names
Imagine Orthodontic Studio
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ANDREW HESS DMD, MS (OWNER)
(727) 743-8307
Entity
Organization
Contact information
Practice address
1581 MISSOURI AVE N, LARGO, FL 33770-1853
(727) 724-2400
Mailing address
7348 US 19 N, PINELLAS PARK, FL 33781-4600
(727) 865-5711
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108070900
—
FL
Enumeration date
10/14/2022
Last updated
10/14/2022
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