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General NPI Number Information
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NPI Number | 1245457183
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Entity Type | Individual
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Provider Name | DANA M BUSCIGLIO DIAZ DMD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 5601 SKYTOP DR
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City | LITHIA
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State | FL
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Zip | 33547
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Country | US
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Telephone | 813-603-8800
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Fax | 813-603-8801
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Provider Business Mailing Address
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Address Line | 5601 SKYTOP DR
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City | LITHIA
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State | FL
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Zip | 33547-4165
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Country | US
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Telephone | 813-603-8800
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Fax | 813-603-8801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 16945
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN16945
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN16945
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License Number State | FL
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