Provider Demographics
NPI:1598203440
Name:FAMILY DENTISTRY OF HERNANDO, INC
Entity Type:Organization
Organization Name:FAMILY DENTISTRY OF HERNANDO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-596-7388
Mailing Address - Street 1:5080 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1929
Mailing Address - Country:US
Mailing Address - Phone:352-596-7388
Mailing Address - Fax:352-596-7174
Practice Address - Street 1:5080 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1929
Practice Address - Country:US
Practice Address - Phone:352-596-7388
Practice Address - Fax:352-596-7174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty