Organization
CROWN DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUGO RUIZ DOCTOR (OWNER)
(813) 873-0271
Entity
Organization
Contact information
Practice address
4812 N HABANA AVE, TAMPA, FL 33614-6871
(813) 873-0271
(813) 873-2929
Mailing address
4812 N HABANA AVE, TAMPA, FL 33614-6871
(813) 873-0271
(813) 873-2929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN12639
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073641400
—
FL
Enumeration date
08/17/2011
Last updated
08/17/2011
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