Organization
SYLMAR FAMILY DENTAL PRACTICE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS J GUTIERREZ DIAZ DDS (PRESIDENT)
(818) 384-4120
Entity
Organization
Contact information
Practice address
15283 AMBERLY DR, TAMPA, FL 33647-2155
(813) 898-2523
Mailing address
15283 AMBERLY DR, TAMPA, FL 33647-2155
(813) 898-2523
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2021
Last updated
01/09/2021
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