Provider Demographics
NPI:1821830209
Name:LAF DENTAL STUDIO INC
Entity type:Organization
Organization Name:LAF DENTAL STUDIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST -OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-763-5346
Mailing Address - Street 1:2708 W VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6380
Mailing Address - Country:US
Mailing Address - Phone:305-763-5346
Mailing Address - Fax:
Practice Address - Street 1:2708 W VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6380
Practice Address - Country:US
Practice Address - Phone:305-763-5346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty