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NPI Code Detail

MEDICARE: ELIZABETH R DY DMD

MEDICARE: ELIZABETH R DY DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN19354FL

General Provider Information

NPI Number : 1558656736
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH R DY DMD
Provider Business Mailing Address
First Line : 6025 MEMORIAL HWY
Second Line :
City : TAMPA
State : FL
Zip : 33615-4531
Country : US
Telephone Number : 813-886-2527
Fax Number : 813-887-3225
Provider Business Practice Location Address
First Line : 6025 MEMORIAL HWY
Second Line :
City : TAMPA
State : FL
Zip : 33615-4531
Country : US
Telephone Number : 813-886-2527
Fax Number : 813-887-3225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2011
Last Update Date : 06/13/2014

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Directions to “ ELIZABETH R DY DMD” Practice Location

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