Provider Demographics
NPI:1235342700
Name:DIAZ, JOSEPH FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANK
Last Name:DIAZ
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 1:705 DEL WEBB BLVD W
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5232
Mailing Address - Country:US
Mailing Address - Phone:813-633-1431
Mailing Address - Fax:813-642-0643
Practice Address - Street 1:705 DEL WEBB BLVD W
Practice Address - Street 2:SUITE B
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5232
Practice Address - Country:US
Practice Address - Phone:813-633-1431
Practice Address - Fax:813-642-0643
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice