Individual
KIMBERLY PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
12813 N DALE MABRY HWY, TAMPA, FL 33618-2803
(813) 962-1400
Mailing address
7810 BROADSTONE LOOP, APT 103, TAMPA, FL 33625-2456
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 19933
FL
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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