Provider Demographics
NPI:1518925700
Name:MCDONALD, GAIL C (DDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:C
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 N BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-4627
Mailing Address - Country:US
Mailing Address - Phone:813-209-0338
Mailing Address - Fax:813-209-0388
Practice Address - Street 1:3911 N BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-4627
Practice Address - Country:US
Practice Address - Phone:813-209-0338
Practice Address - Fax:813-209-0196
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00142041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice