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Organization

DEEP ROOTS DENTAL AND FACIAL ASETHETICS LLC

Active
Other names
Deep Roots Dental And Facial Asethetics LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARNIE CHALL BAUER DMD (OWNER)
(813) 839-2273
Entity
Organization

Contact information

Practice address
3013 ALLEGRA WAY, LUTZ, FL 33559-6997
(813) 839-2273
Mailing address
4509 W CULBREATH AVE, TAMPA, FL 33609-4205

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/16/2024
Last updated
12/16/2024
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