| Apd - Tacachale | |
|
1621 Ne Waldo Rd Gainesville FL 32609-3900 | |
| (352) 955-5616 | |
| Not Available |
| Full Name | Apd - Tacachale |
|---|---|
| Speciality | Dentist |
| Location | 1621 Ne Waldo Rd, Gainesville, Florida |
| Authorized Official Name and Position | Don E Thomas (SUPERINTENDENT) |
| Authorized Official Contact | 3529555856 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Apd - Tacachale 1621 Ne Waldo Rd Gainesville FL 32609-3900 Ph: (352) 955-5668 | Apd - Tacachale 1621 Ne Waldo Rd Gainesville FL 32609-3900 Ph: (352) 955-5616 |
| NPI Number | 1275771560 |
|---|---|
| Provider Enumeration Date | 01/26/2009 |
| Last Update Date | 03/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275771560 | NPI | - | NPPES |
| 681084596 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN8807 (Florida) | Primary |
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