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General NPI Number Information
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NPI Number | 1144343948
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Entity Type | Organization
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Legal Business Name | MANTIONE & MANTIONE, D.M.D., P.A.
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Dates
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Enumeration Date | 04/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6967 SUNSET DR S
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City | SOUTH PASADENA
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State | FL
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Zip | 33707-2817
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Country | US
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Telephone | 727-381-6929
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Fax | 727-347-4009
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Provider Business Mailing Address
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Address Line | 6967 SUNSET DR S
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City | SOUTH PASADENA
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State | FL
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Zip | 33707-2817
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Country | US
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Telephone | 727-381-6929
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Fax | 727-347-4009
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Authorized Official
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Title or Position | DENTIST-OWNER
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Name | DR. JOSEPH CHARLES MANTIONE
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Credential | D.M.D.
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Telephone | 727-381-6929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN15699
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License Number State | FL
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