| Community Health Center Clearwater Dental | |
|
702 Jasmine Way Clearwater FL 33756-3951 | |
| (727) 824-8181 | |
| Not Available |
| Full Name | Community Health Center Clearwater Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 702 Jasmine Way, Clearwater, Florida |
| Authorized Official Name and Position | Elodie Dorso (CEO) |
| Authorized Official Contact | 7278248100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Clearwater Dental Po Box 10549 St Petersburg FL 33733-0549 Ph: (727) 824-8181 | Community Health Center Clearwater Dental 702 Jasmine Way Clearwater FL 33756-3951 Ph: (727) 824-8181 |
| NPI Number | 1760807218 |
|---|---|
| Provider Enumeration Date | 02/20/2014 |
| Last Update Date | 12/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760807218 | NPI | - | NPPES |
| 029565519 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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