MEDICARE: DR. DAVID AARON WOODRUFF D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	56226	CA
2	1223G0001X	General Practice Dentistry	DN28160	FL

General Provider Information

NPI Number	:	1023017225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID AARON WOODRUFF D.D.S

Provider Business Mailing Address
First Line	:	100 MADRID BLVD UNIT 414
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-8929
Country	:	US
Telephone Number	:	941-265-0979
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 MADRID BLVD UNIT 414
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-8929
Country	:	US
Telephone Number	:	941-265-0979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	01/15/2024

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