MEDICARE: LAWRENCE J PIJUT DMD PA

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN0013681	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881731891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE J PIJUT DMD PA

Provider Business Mailing Address
First Line	:	2560 CAPITAL MEDICAL BLVD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4424
Country	:	US
Telephone Number	:	850-216-2500
Fax Number	:	850-216-2534

Provider Business Practice Location Address
First Line	:	2560 CAPITAL MEDICAL BLVD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4424
Country	:	US
Telephone Number	:	850-216-2500
Fax Number	:	850-216-2534

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LAWRENCE JOSEPH PIJUT
Credential	:	DMD
Telephone Number	:	850-216-2500

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	12/10/2008

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