NPI 1154643377

International Center for Complete Dentistry

Organisation Customized Equipment (DME) Saint Petersburg, FL

Practice location

Address: 111 2nd Ave NE #1104, Saint Petersburg, FL 33701-3434
Phone: (727) 821-4433
Fax: (727) 822-7252

Authorised official

Name: Dreama Michelle Wegzyn
Title: RN, Office Manager
Phone: (727) 821-4433

Registered specialties

Customized Equipment (DME) Primary

Suppliers Taxonomy 332BC3200X Licence DN4596 (FL)

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Registry record

NPI: 1154643377
Entity type: Organization
NPI issued: 16 Feb 2010
Record last updated: 23 Jun 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.