Provider Demographics
NPI:1164785507
Name:NEW ZEPHYRHILLS DENTAL
Entity Type:Organization
Organization Name:NEW ZEPHYRHILLS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLE-DONNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-783-3700
Mailing Address - Street 1:37039 S.R. 54 WEST
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7039
Mailing Address - Country:US
Mailing Address - Phone:813-783-3700
Mailing Address - Fax:813-783-9242
Practice Address - Street 1:37039 S.R. 54 WEST
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7039
Practice Address - Country:US
Practice Address - Phone:813-783-3700
Practice Address - Fax:813-783-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL122300000XOtherDENTIST