Individual
DR. RALPH J DEDOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11012 N DALE MABRY HWY, TAMPA, FL 33618
(813) 961-1313
(813) 961-6595
Mailing address
11012 N DALE MABRY HWY, TAMPA, FL 33618
(813) 961-1313
(813) 961-6595
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
4377
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6333
FL
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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