Organization
COMMUNITY DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH KAVOUKLIS (PRESIDENT)
(813) 793-7032
Entity
Organization
Contact information
Practice address
4010 W STATE ST, TAMPA, FL 33609-1264
(813) 793-7032
(813) 441-1986
Mailing address
4010 W STATE ST, TAMPA, FL 33609-1264
(813) 793-7032
(813) 441-1986
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10929
FL
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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