MEDICARE: MUSCARO AND MARTINI DENTISTRY

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1992364327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSCARO AND MARTINI DENTISTRY

Provider Business Mailing Address
First Line	:	3502 W BAY TO BAY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-7045
Country	:	US
Telephone Number	:	813-839-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	3502 W BAY TO BAY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-7045
Country	:	US
Telephone Number	:	813-839-6999
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	KRISTEN JOHNSON
Credential	:
Telephone Number	:	813-831-6999

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	06/10/2019

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Directions to “MUSCARO AND MARTINI DENTISTRY ” Practice Location

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