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NPI Code Detail

MEDICARE: DENTAL ASSOCIATES OF TAMPA

MEDICARE: DENTAL ASSOCIATES OF TAMPA
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
1122300000XDentistDN17074FL

General Provider Information

NPI Number : 1235403817
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL ASSOCIATES OF TAMPA
Provider Business Mailing Address
First Line : 1311 W BUSCH BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-7709
Country : US
Telephone Number : 813-898-2888
Fax Number :
Provider Business Practice Location Address
First Line : 1311 W BUSCH BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-7709
Country : US
Telephone Number : 813-898-2888
Fax Number :
Authorized Official
Title or Position : OPERATIONS ASSISTANT
Name : CRYSTAL G BLEDSOE
Credential :
Telephone Number : 863-510-5960
Provider Enumeration Date : 02/29/2012
Last Update Date : 02/29/2012

Similar Medicare Providers

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1063671428 — ROBERT M MICHAUD DMD, PA
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Directions to “DENTAL ASSOCIATES OF TAMPA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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