MEDICARE: DR. CESAR AUGUSTO CHILMAZA DDS, MS

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	122300000X	Dentist	1000980	WI
2	122300000X	Dentist	DN21058	FL

General Provider Information

NPI Number	:	1861801490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CESAR AUGUSTO CHILMAZA DDS, MS

Provider Business Mailing Address
First Line	:	2868 OWL AVE
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6440
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2868 OWL AVE
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6440
Country	:	US
Telephone Number	:	954-675-3742
Fax Number	:

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

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	10/12/2015

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