Provider Demographics
NPI:1114386091
Name:SWEETING, TAMARRA (DMD)
Entity Type:Individual
Prefix:
First Name:TAMARRA
Middle Name:
Last Name:SWEETING
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 1:8900 SW 168TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4569
Mailing Address - Country:US
Mailing Address - Phone:786-430-1051
Mailing Address - Fax:
Practice Address - Street 1:8900 SW 168TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-4569
Practice Address - Country:US
Practice Address - Phone:786-430-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL213091223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health