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NPI Code Detail

MEDICARE: DR. DAVID EDWARD DONALD D.D.S.

MEDICARE: DR. DAVID EDWARD DONALD D.D.S.
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
11223P0221XPediatric DentistryDN 18170FL
21223P0221XPediatric DentistryDN18170FL

General Provider Information

NPI Number : 1750495404
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID EDWARD DONALD D.D.S.
Provider Business Mailing Address
First Line : 365 WEKIVA SPRINGS RD STE 121
Second Line :
City : LONGWOOD
State : FL
Zip : 32779-3690
Country : US
Telephone Number : 321-295-7893
Fax Number :
Provider Business Practice Location Address
First Line : 365 WEKIVA SPRINGS RD STE 121
Second Line :
City : LONGWOOD
State : FL
Zip : 32779-3690
Country : US
Telephone Number : 321-295-7893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/21/2022

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