MEDICARE: DR. EDWARD LLOYD PAIKOFF 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	1223P0300X	Periodontics	DN9690	FL

General Provider Information

NPI Number	:	1144341314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD LLOYD PAIKOFF D.D.S.

Provider Business Mailing Address
First Line	:	5942 OHIO AVE
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-1965
Country	:	US
Telephone Number	:	727-843-0099
Fax Number	:	727-843-3705

Provider Business Practice Location Address
First Line	:	5942 OHIO AVE
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-1965
Country	:	US
Telephone Number	:	727-843-0099
Fax Number	:	727-843-3705

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/08/2007

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