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General NPI Number Information
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NPI Number | 1407454960
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Entity Type | Organization
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Legal Business Name | PETER TSAMBAZIS DMD, P.A.
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 6654 COLLIER BLVD UNIT 104
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City | NAPLES
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State | FL
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Zip | 34114-8179
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Country | US
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Telephone | 917-692-3160
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Fax |
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Provider Business Mailing Address
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Address Line | 26670 ROSEWOOD POINTE CIR UNIT 102
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7534
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Country | US
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Telephone | 917-692-3160
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER D TSAMBAZIS
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Credential | DMD
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Telephone | 917-692-3160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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