Healthcare Provider Details

I. General information

NPI: 1295124386
Provider Name (Legal Business Name): PAPPAS & TAPLEY ORTHODONTICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 NW 76TH DR
GAINESVILLE FL
32607-1593
US

IV. Provider business mailing address

320 NW 76TH DR
GAINESVILLE FL
32607-1593
US

V. Phone/Fax

Practice location:
  • Phone: 352-332-7466
  • Fax: 352-332-4322
Mailing address:
  • Phone: 352-332-7466
  • Fax: 352-332-4322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN11661
License Number StateFL

VIII. Authorized Official

Name: DR. JANET D PAPPAS
Title or Position: PRESIDENT
Credential: D.M.D
Phone: 352-332-7466