Provider Demographics
NPI:1710393806
Name:ALL DENTAL TAMPA, INC
Entity Type:Organization
Organization Name:ALL DENTAL TAMPA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-837-2380
Mailing Address - Street 1:3814 W BAY VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-1226
Mailing Address - Country:US
Mailing Address - Phone:813-837-2380
Mailing Address - Fax:813-837-2381
Practice Address - Street 1:3814 W BAY VISTA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-1226
Practice Address - Country:US
Practice Address - Phone:813-837-2380
Practice Address - Fax:813-837-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0026AOtherBCBS