Organization
PEDIATRIC DENTISTRY OF NEW TAMPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTA MILAGROS RIVERA D.M.D. (PRESIDENT/OWNER)
(813) 374-0388
Entity
Organization
Contact information
Practice address
5326 PRIMROSE LAKE CIR, TAMPA, FL 33647-3589
(813) 374-0388
(813) 374-0390
Mailing address
5326 PRIMROSE LAKE CIR, TAMPA, FL 33647-3589
(813) 374-0388
(813) 374-0390
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN14483
FL
1223P0221X
Pediatric Dentistry
DN19520
FL
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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