Organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL WALKER (CREDENTIALING MANAGER)
(770) 744-4522
Entity
Organization
Contact information
Practice address
2707 TAMPA RD, PALM HARBOR, FL 34684-3312
(727) 785-6521
Mailing address
342 N MAIN ST STE 200, ALPHARETTA, GA 30009-8376
(770) 744-4522
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
08/11/2021
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