Organization
COAST SOUTH TAMPA PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE FINNELL (DIRECTOR OF CREDENTIALING)
(813) 350-7160
Entity
Organization
Contact information
Practice address
5706 BENJAMIN CENTER DR STE 103, TAMPA, FL 33634
(813) 350-7160
(813) 434-2325
Mailing address
5706 BENJAMIN CENTER DR STE 103, TAMPA, FL 33634-5262
(813) 350-7160
(813) 434-2325
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/27/2006
Last updated
07/09/2020
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