Provider Demographics
NPI:1326663758
Name:WESLEY CHAPEL FAMILY DENTAL, P.A.
Entity Type:Organization
Organization Name:WESLEY CHAPEL FAMILY DENTAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHILPA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-817-6668
Mailing Address - Street 1:5879 ARGERIAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545
Mailing Address - Country:US
Mailing Address - Phone:813-445-6668
Mailing Address - Fax:
Practice Address - Street 1:5879 ARGERIAN DRIVE
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545
Practice Address - Country:US
Practice Address - Phone:813-445-6668
Practice Address - Fax:813-445-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty