Organization
COAST DENTAL P.A.
Active
Parent organization
COAST DENTAL P.A.
Other names
Coast Dental-Tallahassee
Organization subpart
Yes
Provider details
NPI number
Legal business name
COAST DENTAL P.A.
Authorized official
MELODY RIVERA (CREDENTIALING MANAGER)
(813) 350-7166
Entity
Organization
Contact information
Practice address
1329 MAHAN DR, TALLAHASSEE, FL 32308-5107
(850) 878-7999
(850) 942-2681
Mailing address
5706 BENJAMIN CENTER DR STE 103, TAMPA, FL 33634-5262
(813) 288-1999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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