MEDICARE: TDN DENTISTRY, PLLC

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	1223P0106X	Oral and Maxillofacial Pathology Dentistry

General Provider Information

NPI Number	:	1932064805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TDN DENTISTRY, PLLC

Provider Business Mailing Address
First Line	:	5117 J TURNER BUTLER BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6080
Country	:	US
Telephone Number	:	904-637-8070
Fax Number	:

Provider Business Practice Location Address
First Line	:	5117 J TURNER BUTLER BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6080
Country	:	US
Telephone Number	:	904-637-8070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY MUSCARO
Credential	:	DDS
Telephone Number	:	813-692-2200

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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