Healthcare Provider Details

I. General information

NPI: 1932240645
Provider Name (Legal Business Name): JOHN J. TOTERA D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 E COLLEGE AVE
RUSKIN FL
33570-5220
US

IV. Provider business mailing address

3070 E COLLEGE AVE
RUSKIN FL
33570-5220
US

V. Phone/Fax

Practice location:
  • Phone: 813-641-2945
  • Fax:
Mailing address:
  • Phone: 813-641-2945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI014140000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN26674
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: