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Individual

CINDY ROARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
4010 W BOY SCOUT BLVD, SUITE 1100, TAMPA, FL 33607-5727
(813) 288-1999
Mailing address
4010 W BOY SCOUT BLVD, SUITE 1100, TAMPA, FL 33607-1421
(813) 288-1999

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DS0000008295
TN
1223G0001X
General Practice Dentistry
Primary
16590
FL
1223G0001X
General Practice Dentistry
DN013293
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001835600
FL
Enumeration date
09/05/2006
Last updated
04/10/2015
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