MEDICARE: DAVID A GEORGE

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
1	1223G0001X	General Practice Dentistry	DS042835	PA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	122300000X	Dentist	DN27609	FL

General Provider Information

NPI Number	:	1568023331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID A GEORGE

Provider Business Mailing Address
First Line	:	11224 CAVALIER PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2676
Country	:	US
Telephone Number	:	856-397-5146
Fax Number	:

Provider Business Practice Location Address
First Line	:	4009 TAMPA RD STE 6
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3232
Country	:	US
Telephone Number	:	813-448-7828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2019
Last Update Date	:	07/06/2025

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Directions to “ DAVID A GEORGE ” Practice Location

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