Provider Demographics
NPI:1417017484
Name:ANGELLA TOMLINSON DDS P.A.
Entity Type:Organization
Organization Name:ANGELLA TOMLINSON DDS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-209-0338
Mailing Address - Street 1:3911 N BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-4627
Mailing Address - Country:US
Mailing Address - Phone:813-209-0338
Mailing Address - Fax:
Practice Address - Street 1:3911 N BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-4627
Practice Address - Country:US
Practice Address - Phone:813-209-0338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL115321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty