Implants, Periodontics & Facial Rejuvenation

NPI 1104198282 - Clinic/Center - 261QD0000X

NPI Details
NPI 1104198282
Enumeration Date 02/03/2012
Last Updated 02/03/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name TODD MERRELL TODD
Position CEO
Phone (813) 299-3867
Fax
Practice Location
2346 CREEL LN STE 101
WESLEY CHAPEL FL, 33544-4623, US
Phone (813) 299-3867
Fax
Business Location
2346 CREEL LANE #101
WESLEY CHAPEL FL, 33544, US
Phone (813) 299-3867
Fax
Toxanomy
Taxonomy Code 261QD0000X
License State Florida
License Number DN012810
Remove 1104198282 NPI Number
 

According to our database, Implants, Periodontics & Facial Rejuvenation NPI is 1104198282, taxonomy code is 261QD0000X and license number is DN012810, license state is located at Florida. Implants, Periodontics & Facial Rejuvenation physically located at 2346 Creel Ln Ste 101, Wesley Chapel FL, 33544-4623. NPI Number 1033115704 has the healthcare provider type.

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1104198282 NPI number is provided on an as is basis without warranty of any kind. 1104198282 is maintained by the National Plan & Provider Enumeration System. The contents of Implants, Periodontics & Facial Rejuvenation are for informational purposes only.