Organization
BAYSHORE PEDIATRIC DENTISTRY AND ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA VICE (DENTIST)
(813) 324-1535
Entity
Organization
Contact information
Practice address
8002 BEATY GROVE DR, TAMPA, FL 33626-1601
(813) 324-1535
Mailing address
11941 WANDSWORTH DR, TAMPA, FL 33626-2612
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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