| Kids Smiles Dental, Pllc | |
|
1773 W Fletcher Ave Tampa FL 33612 | |
| (813) 968-2483 | |
| Not Available |
| Full Name | Kids Smiles Dental, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1773 W Fletcher Ave, Tampa, Florida |
| Authorized Official Name and Position | Neely Jordan (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8139682483 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Smiles Dental, Pllc 1773 W Fletcher Ave Tampa FL 33612-1820 Ph: (813) 968-2483 | Kids Smiles Dental, Pllc 1773 W Fletcher Ave Tampa FL 33612 Ph: (813) 968-2483 |
| NPI Number | 1033661848 |
|---|---|
| Provider Enumeration Date | 10/27/2016 |
| Last Update Date | 07/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033661848 | NPI | - | NPPES |
| 017306300 | Medicaid | FL | |
| 075109000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN13285 (Florida) | Primary |
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