Organization
THEODORE EDWARD DAVID PETERS, DDS,PA
Active
Organization
THEODORE EDWARD DAVID PETERS, DDS,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE EDWARD DAVID PETERS DDS (SURGEON)
(813) 870-1220
Entity
Organization
Contact information
Practice address
508 S HABANA AVE, SUITE 110, TAMPA, FL 33609-4181
(813) 870-1220
(813) 870-2615
Mailing address
508 S HABANA AVE, SUITE 110, TAMPA, FL 33609-4181
(813) 870-1220
(813) 870-2615
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
13473
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457342750
NPI
—
Enumeration date
03/05/2008
Last updated
03/05/2008
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