Organization
HOLLYWOOD SMILE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE ENDRIS (OPERATIONS MANAGER)
(727) 202-1053
Entity
Organization
Contact information
Practice address
32919 US HIGHWAY 19 N, PALM HARBOR, FL 34684-3121
(727) 202-1054
(844) 727-9580
Mailing address
2702 TAMPA RD, PALM HARBOR, FL 34684-3311
(727) 781-2424
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13292
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
13292
FL
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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