MEDICARE: MICHAEL A. PIKOS, D.D.S., P.A.

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)

General Provider Information

NPI Number	:	1942456025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A. PIKOS, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	2711 TAMPA RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3312
Country	:	US
Telephone Number	:	727-786-1631
Fax Number	:	727-785-8477

Provider Business Practice Location Address
First Line	:	8845 HAWBUCK ST
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-5361
Country	:	US
Telephone Number	:	727-786-1631
Fax Number	:	727-785-8477

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL A. PIKOS
Credential	:	D.D.S.
Telephone Number	:	727-786-1631

Provider Enumeration Date	:	08/08/2008
Last Update Date	:	08/08/2008

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