Park Boulevard Family Dentistry
NPI #1578170684 in Pinellas Park, Florida
Provider Information
- NPI Number
- 1578170684
- Entity Type
- Organization
- Organization Name
- Park Boulevard Family Dentistry
- Primary Specialty
- Dentist
- Enumeration Date
- Sep 24, 2020
- Last Updated
- Sep 24, 2020
Practice Location
- Address
- 4326 PARK BLVD N STE A
- City
- Pinellas Park
- State
- Florida
- ZIP Code
- 33781-3538
- Phone
- (727) 291-0220
Authorized Official
- Name
- BRIANNE LEIGH WADE, DMD
- Title
- OWNER/PRESIDENT/DENTIST
- Phone
- (813) 244-6045
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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