Contract Details
EZ Comp Care, Inc.
Facility name
EZ Dental Care, Inc.
Provider ID
P000009166
NPI
1891157376
Tax ID
811842202
Effective Date
5/23/2018
Last Updated
5/24/2018
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_384
Location Details
Address
2909 Bay To Bay Blvd. Suite 410
Tampa, FL 33611
United States
County
Hillsborough
Phone
8559392997 (Phone)
Billing Details
Address
P.O. Box 6787
Brandon, FL 33511
Billing Phone
8559392667
Specialty Type
Dentistry
Map
Address