| Tampa Bay Periodontics And Implant Dentistry | |
|
1810 S Macdill Ave Ste 2 Tampa FL 33629-5901 | |
| (813) 251-0770 | |
| (813) 251-0771 |
| Full Name | Tampa Bay Periodontics And Implant Dentistry |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1810 S Macdill Ave, Tampa, Florida |
| Authorized Official Name and Position | James G Wilson (PRESIDENT) |
| Authorized Official Contact | 8132510770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tampa Bay Periodontics And Implant Dentistry 1810 S Macdill Ave Ste 2 Tampa FL 33629-5901 Ph: (813) 251-0770 | Tampa Bay Periodontics And Implant Dentistry 1810 S Macdill Ave Ste 2 Tampa FL 33629-5901 Ph: (813) 251-0770 |
| NPI Number | 1679564405 |
|---|---|
| Provider Enumeration Date | 11/01/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679564405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DN13537 (Florida) | Primary |
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