Organization
PERIODONTAL HEALTH CENTER, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA STILLEY DMD (PERIODONTIST)
(727) 847-1239
Entity
Organization
Contact information
Practice address
5522 GULF DR, NEW PORT RICHEY, FL 34652-4022
(727) 847-1239
(727) 845-4595
Mailing address
5522 GULF DR, NEW PORT RICHEY, FL 34652-4022
(727) 847-1239
(727) 845-4595
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN17194
FL
1223P0300X
Periodontics
DN6888
FL
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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