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Individual

ANASTASIA AVINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
1060 W BUSCH BLVD, 105, TAMPA, FL 33612-7707
(813) 931-4000
Mailing address
12395 EL CAMINO REAL STE 101, SAN DIEGO, CA 92130-3083

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN19505
FL
1223G0001X
General Practice Dentistry
Primary
DN63067
CA

Other

Enumeration date
09/21/2011
Last updated
02/20/2020
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