Organization
CODIMS OF TAMPA BAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNESTO VALIENTE DMD (GENERAL MANAGER)
(813) 968-5400
Entity
Organization
Contact information
Practice address
6515 GUNN HWY, TAMPA, FL 33625-4021
(813) 968-5400
(813) 968-4433
Mailing address
6515 GUNN HWY, TAMPA, FL 33625-4021
(813) 968-5400
(813) 968-4433
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
15074
FL
Other
Enumeration date
08/07/2007
Last updated
08/20/2014
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