DUSTIN DEDOMENICO

TAMPA, FL
NPI1902224975
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: FL  DN20727)
Additional Taxonomies122300000X Dentist
(Licence: KY  KY 9443)
Enumeration Date2014-04-07
Last Update Date2016-09-24
Business Address
-- DUSTIN DEDOMENICO DMD MS
11012 N DALE MABRY HWY STE 302
TAMPA, FL 33618-3821
Phone number: 813-961-1414
Mailing Address
-- DUSTIN DEDOMENICO DMD MS
11012 N DALE MABRY HWY STE 302
TAMPA, FL 33618-3821
Phone number: 813-961-1414