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Organization

COASTAL DENTAL AESTHETICS ENTERPRISE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EMILY NABUT DMD (OWNER/DOCTOR)
(919) 943-0279
Entity
Organization

Contact information

Practice address
4001 16TH ST N, ST PETERSBURG, FL 33703-5605
(919) 943-0279
Mailing address
210 MADISON ST S, ST PETERSBURG, FL 33711-1251
(919) 943-0279

Taxonomy

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

Other

Enumeration date
07/09/2026
Last updated
07/09/2026
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