Individual
ERICA VICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
313 S LAKEWOOD DR, BRANDON, FL 33511-2815
(813) 653-6271
Mailing address
313 S LAKEWOOD DR, BRANDON, FL 33511-2815
(813) 653-6271
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN25724
FL
1223P0221X
Pediatric Dentistry
DEN03298
RI
1223P0221X
Pediatric Dentistry
Primary
DN25724
FL
Other
Enumeration date
02/02/2016
Last updated
06/20/2021
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