Healthcare Provider Details

I. General information

NPI: 1871791350
Provider Name (Legal Business Name): MICHAEL REX LINDSAY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD ROOM D4-4
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100405
GAINESVILLE FL
32610-0405
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5800
  • Fax: 352-392-3070
Mailing address:
  • Phone: 352-273-5440
  • Fax: 352-392-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDRP 570
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: