MEDICARE: DR. MATTHEW T NAVIDOMSKIS DMD, MPH

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	122300000X	Dentist	DN18667	FL

General Provider Information

NPI Number	:	1992932123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW T NAVIDOMSKIS DMD, MPH

Provider Business Mailing Address
First Line	:	2616 TAMIAMI TRL
Second Line	:	SUITE #8
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-6473
Country	:	US
Telephone Number	:	941-249-9383
Fax Number	:

Provider Business Practice Location Address
First Line	:	2616 TAMIAMI TRL
Second Line	:	SUITE #8
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-6473
Country	:	US
Telephone Number	:	941-249-9383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2009
Last Update Date	:	03/09/2016

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