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NPI Code Detail

MEDICARE: DR. AMANDA PUUSTINEN DMD

MEDICARE: DR. AMANDA PUUSTINEN 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 DentistryDN26953FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DN26953OTHERFLMEDICAL LICENSE

General Provider Information

NPI Number : 1982331260
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA PUUSTINEN DMD
Provider Business Mailing Address
First Line : PO BOX 82969
Second Line :
City : TAMPA
State : FL
Zip : 33682-2969
Country : US
Telephone Number : 813-397-5300
Fax Number : 813-405-3722
Provider Business Practice Location Address
First Line : 6216 E SLIGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33617-9105
Country : US
Telephone Number : 813-397-5300
Fax Number : 813-738-9006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2022
Last Update Date : 09/22/2023

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Directions to “ DR. AMANDA PUUSTINEN DMD” Practice Location

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