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General NPI Number Information
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NPI Number | 1427551829
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Entity Type | Organization
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Legal Business Name | TODD R DENSON, DMD
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2191 GARDEN ST
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City | TITUSVILLE
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State | FL
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Zip | 32796-2577
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Country | US
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Telephone | 321-269-5701
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Fax | 321-268-0691
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Provider Business Mailing Address
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Address Line | 2191 GARDEN ST
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City | TITUSVILLE
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State | FL
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Zip | 32796-2577
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Country | US
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Telephone | 321-269-5701
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Fax | 321-268-0691
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. RITA SEALE
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Credential |
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Telephone | 321-269-5701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 13298
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License Number State | FL
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