Organization
DEEP ROOTS PROJECT, LLC
Active
Other names
Deep Roots Project LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER NICOLE VEGA (PRACTICE MANAGER)
(813) 839-2273
Entity
Organization
Contact information
Practice address
4302 HENDERSON BLVD STE 117, TAMPA, FL 33629-5693
(813) 839-2273
(813) 839-2206
Mailing address
4302 HENDERSON BLVD STE 117, TAMPA, FL 33629-5693
(813) 839-2273
(813) 839-2206
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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