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NPI Code Detail

MEDICARE: DR. TIFFANY MELISSA DUDLEY DDS

MEDICARE:  DR. TIFFANY MELISSA DUDLEY  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
1122300000XDentistDN18099FL
2122300000XDentist2901019615MI

General Provider Information

NPI Number : 1679720247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY MELISSA DUDLEY DDS
Provider Business Mailing Address
First Line : 3911 W. ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445
Country : US
Telephone Number : 561-498-0050
Fax Number : 561-498-0841
Provider Business Practice Location Address
First Line : 3911 W ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3902
Country : US
Telephone Number : 561-498-0050
Fax Number : 561-498-0841
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2008
Last Update Date : 12/08/2014

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Directions to “ DR. TIFFANY MELISSA DUDLEY DDS” Practice Location

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