| NPI | 1457236267 |
|---|---|
| Doing Business As | PINE AVENUE SMILES |
| Entity Type | Organization |
| Authorized Contact | MATTHEW SORSOK Dentist Owner 813-476-5978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2026-03-23 |