Provider Demographics
NPI:1164513578
Name:GEIST, ERIC C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:GEIST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4364 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1965
Mailing Address - Country:US
Mailing Address - Phone:352-596-1771
Mailing Address - Fax:352-596-6067
Practice Address - Street 1:4364 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1965
Practice Address - Country:US
Practice Address - Phone:352-596-1771
Practice Address - Fax:352-596-6067
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN161681223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics