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Organization

GRAND DENTAL, LLC

Active
Parent organization
GRAND DENTAL, LLC
Other names
Carrollwood Smiles
Organization subpart
Yes

Provider details

NPI number
Legal business name
GRAND DENTAL, LLC
Authorized official
SYLVIA JESSENE MILLER (INSURANCE COORDINATOR)
(321) 431-2208
Entity
Organization

Contact information

Practice address
3401 W FLETCHER AVE, SUITE A, TAMPA, FL 33618-2813
(813) 269-4000
(813) 269-4001
Mailing address
3401 W FLETCHER AVE, SUITE A, TAMPA, FL 33618-2813
(813) 269-4000
(813) 269-4001

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
FL

Other

Enumeration date
10/26/2015
Last updated
11/05/2015
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