Organization
EMERALD COAST DENTAL SPA
Active
Other names
Tara Walling DMD PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA M GRIFFIN DMD PA (PRESIDENT/ OWNER)
(850) 249-9311
Entity
Organization
Contact information
Practice address
900 THOMAS DR, PANAMA CITY BEACH, FL 32408-7442
(850) 249-9311
(850) 249-9312
Mailing address
900 THOMAS DR, PANAMA CITY BEACH, FL 32408-7442
(850) 249-9311
(850) 249-9312
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
305S00000X
Point of Service
17668
FL
Other
Enumeration date
11/24/2008
Last updated
01/28/2020
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