MEDICARE: DENTALWORKS USA

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1518338979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTALWORKS USA

Provider Business Mailing Address
First Line	:	1408 N WEST SHORE BLVD
Second Line	:	STE. 704
City	:	TAMPA
State	:	FL
Zip	:	33607-4525
Country	:	US
Telephone Number	:	855-443-9872
Fax Number	:	877-745-3615

Provider Business Practice Location Address
First Line	:	1408 N WEST SHORE BLVD
Second Line	:	STE. 704
City	:	TAMPA
State	:	FL
Zip	:	33607-4525
Country	:	US
Telephone Number	:	855-443-9872
Fax Number	:	877-745-3615

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. TIM LYONS
Credential	:
Telephone Number	:	855-443-9872

Provider Enumeration Date	:	10/12/2015
Last Update Date	:	10/12/2015

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Directions to “DENTALWORKS USA ” Practice Location

Language	Start Address	Practice Location

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