Provider Demographics
NPI:1740313030
Name:AMBERLY FAMILY DENTISTRY
Entity type:Organization
Organization Name:AMBERLY FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARSHANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-910-3333
Mailing Address - Street 1:14463 UNIVERSITY COVE PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3741
Mailing Address - Country:US
Mailing Address - Phone:813-910-3333
Mailing Address - Fax:813-910-3323
Practice Address - Street 1:14463 UNIVERSITY COVE PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3741
Practice Address - Country:US
Practice Address - Phone:813-910-3333
Practice Address - Fax:813-910-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty