Provider Demographics
NPI:1700911021
Name:PETROPOULOS, TERRYL ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:TERRYL
Middle Name:ANN
Last Name:PETROPOULOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WEST MARTIN LUTHER KING BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1521
Mailing Address - Country:US
Mailing Address - Phone:813-237-1982
Mailing Address - Fax:
Practice Address - Street 1:825 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603
Practice Address - Country:US
Practice Address - Phone:813-237-1982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL135871223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics