TOMAS J. BALLESTEROS D.M.D. PA
Dentist at Desoto St, Clermont, FL

License number
Florida DN0013657
Category
Dentist
Type
General Practice
Owner
Name: DR. TOMAS J. BALLESTEROS DMD
Title: OWNER
Phone: (352) 394-3071
Address
Address
810 W Desoto St, Clermont, FL 34711
National Provider ID: 1013014000
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about TOMAS J. BALLESTEROS D.M.D. PA at bizstanding.com

TOMAS J. BALLESTEROS, DMD, PA

Clermont, FL

Status:
Inactive
Inactive reason:
AMENDMENT
Registration:
Jul 13, 1995
Inactive since:
Sep 18, 1998
Addresses:
810 Desoto St, Clermont, FL 34711 (Physical)
Clermont, FL 34712 (Mailing)
State ID:
P95000054151
Business type:
Florida Profit Corporation
Treasurer, Secretarys:
Tomas J Ballesteros (President, Director, Vice President), Po Box121187, Clermont, FL 34712 (Physical),Joanna C Ballesteros (Secretary, Treasurer), PO Box 121187, Clermont, FL 34712 (Physical),Debra M. Stralis Treasurer, Secretary, inactive
Agent:
Tomas Ballesteros,810 Desoto St, Clermont, FL 34711 (Physical)
EIN:
59-3323145

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