EVERET LAKE

ZEPHYRHILLS, FL
NPI1184792657
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: FL  DN17765)
Enumeration Date2006-12-01
Last Update Date2007-07-08
Business Address
-- EVERET LAKE
4924 S. ALLEN ROAD
ZEPHYRHILLS, FL 33541
Phone number: 813-779-8591
Mailing Address
-- EVERET LAKE
2502 N ROCKY POINT DR SUITE 1000-CREDENTIALING
TAMPA, FL 33607-1421
Phone number:
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