| NPI | 1639560386 |
|---|---|
| Doing Business As | TAMPA FAMILY HEALTH CENTER DENTAL VAN |
| Entity Type | Organization |
| Authorized Contact | CHARLES R. BOTTOMS CEO 813-866-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-02-16 |