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General NPI Number Information
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NPI Number | 1427131325
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Entity Type | Individual
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Provider Name | MICHAEL A TARAS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 123 S. STATE RD 7 SUITE 205
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411
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Country | US
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Telephone | 561-204-3337
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Fax | 561-204-5321
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Provider Business Mailing Address
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Address Line | 123 S. STATE RD 7 SUITE 205
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411
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Country | US
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Telephone | 561-204-3337
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Fax | 561-204-5321
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN-15503
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License Number State | FL
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