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NPI Code Detail

MEDICARE: MICHAEL PATRICK WALDRON DMD

MEDICARE: MICHAEL PATRICK WALDRON DMD
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
11223G0001XGeneral Practice Dentistry28240FL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1902597321
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PATRICK WALDRON DMD
Provider Business Mailing Address
First Line : 8007 US HIGHWAY 19 NORTH
Second Line :
City : PINELLAS PARK
State : FL
Zip : 33758
Country : US
Telephone Number : 845-323-0594
Fax Number :
Provider Business Practice Location Address
First Line : 11225 US HIGHWAY 301 N
Second Line :
City : PARRISH
State : FL
Zip : 34219-8675
Country : US
Telephone Number : 941-418-0001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2023
Last Update Date : 12/03/2025

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