| Park Street Dental | |
|
4911 Park St N Suite A St Petersburg FL 33709-2227 | |
| (727) 548-7733 | |
| (727) 548-0015 |
| Full Name | Park Street Dental |
|---|---|
| Speciality | Dentist |
| Location | 4911 Park St N, St Petersburg, Florida |
| Authorized Official Name and Position | Jose M Garcia (OWNER) |
| Authorized Official Contact | 7275487733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Street Dental 4911 Park St N Suite A St Petersburg FL 33709-2227 Ph: (727) 548-7733 | Park Street Dental 4911 Park St N Suite A St Petersburg FL 33709-2227 Ph: (727) 548-7733 |
| NPI Number | 1154776730 |
|---|---|
| Provider Enumeration Date | 05/02/2016 |
| Last Update Date | 05/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154776730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN11980 (Florida) | Primary |
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