Organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Active
Parent organization
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Other names
Palm Tree Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN AND TEEN DENTAL GROUP OF FLORIDA
Authorized official
BRIAN SMITH (CFO)
(470) 207-3264
Entity
Organization
Contact information
Practice address
2939 ALT 19, PALM HARBOR, FL 34683-1928
(727) 785-6521
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(727) 784-2721
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
10/19/2023
Last updated
01/21/2025
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