Organization
SPOCS ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED MANSOUR (OWNER/ORTHODONTIST)
(917) 209-6466
Entity
Organization
Contact information
Practice address
3200 4TH ST N, ST PETERSBURG, FL 33704-2127
(727) 242-8000
Mailing address
330 43RD AVE N, ST PETERSBURG, FL 33703-4834
(727) 242-8000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/25/2025
Last updated
09/24/2025
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