Organization
ALI FAMILY DENTAL LLC
Active
Other names
Fresh Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOMODU ALI DDS (OWNER)
(813) 453-0414
Entity
Organization
Contact information
Practice address
2510 W VIRGINIA AVE, TAMPA, FL 33607-6326
(813) 453-0414
Mailing address
2510 W VIRGINIA AVE, TAMPA, FL 33607-6326
(813) 453-0414
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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