Organization
LI'L SUNSHINE SMILES DENTISTRY P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATALINA BOTERO DDS (DDS/PRESIDENT)
(719) 289-1799
Entity
Organization
Contact information
Practice address
12950 RACE TRACK RD STE 109, TAMPA, FL 33626-1304
(719) 289-1799
Mailing address
4904 EBENSBURG DR, TAMPA, FL 33647-1381
(719) 289-1799
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023572000
—
FL
Enumeration date
08/12/2019
Last updated
08/12/2019
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