MEDICARE: DR. LINDA AUFDEMBRINK TROTTER DMD

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	1223D0001X	Public Health Dentistry	11386	FL

General Provider Information

NPI Number	:	1306853023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA AUFDEMBRINK TROTTER DMD

Provider Business Mailing Address
First Line	:	2537 OAK STREET
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204
Country	:	US
Telephone Number	:	904-389-3451
Fax Number	:	904-389-8489

Provider Business Practice Location Address
First Line	:	2532 OAK STREET
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204
Country	:	US
Telephone Number	:	904-389-3451
Fax Number	:	904-389-8489

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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