Organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Active
Parent organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Other names
Palm Tree Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Authorized official
NICOLE CARIDE (CREDENTIALING)
(727) 784-2721
Entity
Organization
Contact information
Practice address
5245 US HIGHWAY 19, NEW PORT RICHEY, FL 34652-3967
(727) 847-3113
(727) 847-2904
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(470) 207-3264
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
05/07/2021
Last updated
01/21/2025
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