MEDICARE: TEODORE DENTAL P.A.

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	1223G0001X	General Practice Dentistry	DN 16458	FL

General Provider Information

NPI Number	:	1669684411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEODORE DENTAL P.A.

Provider Business Mailing Address
First Line	:	6901 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6829
Country	:	US
Telephone Number	:	407-292-8767
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6829
Country	:	US
Telephone Number	:	407-292-8767
Fax Number	:	407-292-8400

Authorized Official
Title or Position	:	DENTIST OWNER
Name	:	DR. CATALIN TEODORU
Credential	:	DMD
Telephone Number	:	407-292-8767

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/01/2008

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