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NPI Code Detail

MEDICARE: MR. ALFRED J TENNANT DDS

MEDICARE: MR. ALFRED J TENNANT 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
11223G0001XGeneral Practice DentistryDN13641FL

General Provider Information

NPI Number : 1295909802
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALFRED J TENNANT DDS
Provider Business Mailing Address
First Line : 4200 N ARMENIA AVE STE 3
Second Line :
City : TAMPA
State : FL
Zip : 33607-6451
Country : US
Telephone Number : 813-870-6000
Fax Number :
Provider Business Practice Location Address
First Line : 4200 N ARMENIA AVE STE 3
Second Line :
City : TAMPA
State : FL
Zip : 33607-6451
Country : US
Telephone Number : 813-870-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2008
Last Update Date : 07/24/2023

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