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General NPI Number Information
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NPI Number | 1710781638
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Entity Type | Organization
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Legal Business Name | WEST FLORIDA PERIODONTAL ASSOCIATES, P. A.
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 6111 N DAVIS HWY STE B
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City | PENSACOLA
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State | FL
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Zip | 32504-6913
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Country | US
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Telephone | 850-476-8418
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Fax | 850-474-0057
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Provider Business Mailing Address
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Address Line | 6111 N DAVIS HWY STE B
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City | PENSACOLA
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State | FL
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Zip | 32504-6913
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Country | US
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Telephone | 850-476-8418
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. GREGORY ALAN WOOD
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Credential | DMD, MS
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Telephone | 850-476-8419
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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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