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General NPI Number Information
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NPI Number | 1881763993
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Entity Type | Individual
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Provider Name | MICHAEL F AGNINI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1805 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3062
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Country | US
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Telephone | 863-682-1500
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Fax | 863-682-6318
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Provider Business Mailing Address
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Address Line | 1805 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3062
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Country | US
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Telephone | 863-682-1500
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Fax | 863-682-6318
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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 | 5964
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License Number State | FL
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