Provider Demographics
NPI:1114018397
Name:STARLING, TRACIE C (DMD)
Entity Type:Individual
Prefix:
First Name:TRACIE
Middle Name:C
Last Name:STARLING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SE PALMETTO AVE
Mailing Address - Street 2:PO BOX 919
Mailing Address - City:KEYSTONE HGTS
Mailing Address - State:FL
Mailing Address - Zip Code:32656
Mailing Address - Country:US
Mailing Address - Phone:352-473-9090
Mailing Address - Fax:352-473-1060
Practice Address - Street 1:310 SE PALMETTO AVE
Practice Address - Street 2:
Practice Address - City:KEYSTONE HGTS
Practice Address - State:FL
Practice Address - Zip Code:32656
Practice Address - Country:US
Practice Address - Phone:352-473-9090
Practice Address - Fax:352-473-1060
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0013742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist