MEDICARE: DR. MOPELOLA ADEJOKE ADEWUNMI DMD MPH

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 16260	FL

General Provider Information

NPI Number	:	1477605053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOPELOLA ADEJOKE ADEWUNMI DMD MPH

Provider Business Mailing Address
First Line	:	6350 76TH AVE N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3152
Country	:	US
Telephone Number	:	727-547-7780
Fax Number	:	727-549-6440

Provider Business Practice Location Address
First Line	:	6350 76TH AVE N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3152
Country	:	US
Telephone Number	:	727-547-7780
Fax Number	:	727-549-6440

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	10/26/2011

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