10D2199293 CLIA NUMBER - PAUL T RODEGHERO DDS PA DBA CLEARWATER FAMILY DENTAL

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Laboratory Demographics

CLIA Number: 10D2199293

Facility Name: PAUL T RODEGHERO DDS PA DBA CLEARWATER FAMILY DENTAL

Facility Address:
215 S MYRTLE AVE
CLEARWATER, FL
ZIP 33756
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Facility Phone Number: 727 442-3363

Facility Type: Other - DENTAL

Certificate Type: Waiver

NPI Number: 1689642316

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	10D2199293
LAB Type	Other - DENTAL
Facility Name	PAUL T RODEGHERO DDS PA DBA CLEARWATER FAMILY DENTAL
Street	215 S MYRTLE AVE
City	CLEARWATER
State	FL
ZIP	33756
Phone	727 442-3363
CertificateType	4
CertificateEffectiveDate	11/6/2022
CertificateExpirationDate	11/5/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024