MEDICARE: DR. SALVADOR SPOTO DDS

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	DN 4709	FL
2	1223G0001X	General Practice Dentistry	DN4709	FL

General Provider Information

NPI Number	:	1275780355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVADOR SPOTO DDS

Provider Business Mailing Address
First Line	:	7807 BAY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33635-9726
Country	:	US
Telephone Number	:	813-814-0062
Fax Number	:	813-814-0062

Provider Business Practice Location Address
First Line	:	7807 BAY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33635-9726
Country	:	US
Telephone Number	:	813-814-0062
Fax Number	:	813-814-0062

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

Provider Enumeration Date	:	08/20/2008
Last Update Date	:	08/20/2008

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