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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