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Organization

WEST COAST ENDODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACEY BLAINE (FRONT OFFICE MANAGER)
(727) 787-4005
Entity
Organization

Contact information

Practice address
2654 W LAKE RD, PALM HARBOR, FL 34684-3120
(727) 787-4005
(727) 490-4421
Mailing address
2654 W LAKE RD, PALM HARBOR, FL 34684-3120
(727) 787-4005
(727) 490-4421

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary

Other

Enumeration date
08/31/2020
Last updated
08/31/2020
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