Healthcare Provider Details

I. General information

NPI: 1508087461
Provider Name (Legal Business Name): MICHAEL T. COBBE, DDS, IIPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5456 SPRING HILL DR
SPRING HILL FL
34606-4559
US

IV. Provider business mailing address

2707 TAMPA RD
PALM HARBOR FL
34684-3312
US

V. Phone/Fax

Practice location:
  • Phone: 352-666-1400
  • Fax: 352-666-0600
Mailing address:
  • Phone: 727-785-6521
  • Fax: 727-785-6237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN7557
License Number StateFL

VIII. Authorized Official

Name: MICHAEL TIMOTHY COBBE
Title or Position: EXECUTIVE DIRECTOR
Credential: DDS
Phone: 727-785-6521