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NPI Code Detail

MEDICARE: DR. MICHAEL CLIFFORD HARTLEY D.M.D.

MEDICARE:  DR. MICHAEL CLIFFORD HARTLEY  D.M.D.
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
1122300000XDentistDN0015170FL

General Provider Information

NPI Number : 1043430978
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL CLIFFORD HARTLEY D.M.D.
Provider Business Mailing Address
First Line : 2808 ROYAL ISLE DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32312-4083
Country : US
Telephone Number : 850-668-5587
Fax Number : 850-386-8181
Provider Business Practice Location Address
First Line : 1305 THOMASWOOD DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-7915
Country : US
Telephone Number : 850-386-2400
Fax Number : 850-386-8181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 07/08/2007

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Directions to “ DR. MICHAEL CLIFFORD HARTLEY D.M.D.” Practice Location

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