Provider Demographics
NPI:1861614356
Name:KAMILLA SZTANKO DMD
Entity type:Organization
Organization Name:KAMILLA SZTANKO DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SZTANKO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-789-4044
Mailing Address - Street 1:3830 TAMPA RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-5619
Mailing Address - Country:US
Mailing Address - Phone:727-789-4044
Mailing Address - Fax:
Practice Address - Street 1:3830 TAMPA RD
Practice Address - Street 2:STE. 100
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-5619
Practice Address - Country:US
Practice Address - Phone:727-789-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL115301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty