Provider Demographics
NPI:1023217700
Name:MUELLER & WALDING, PA
Entity Type:Organization
Organization Name:MUELLER & WALDING, PA
Other - Org Name:PARKWAY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-607-9030
Mailing Address - Street 1:3845 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1109
Mailing Address - Country:US
Mailing Address - Phone:863-607-9030
Mailing Address - Fax:863-607-9033
Practice Address - Street 1:3845 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1109
Practice Address - Country:US
Practice Address - Phone:863-607-9030
Practice Address - Fax:863-607-9033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty