Provider Demographics
NPI:1669817532
Name:HEDGER, PHILIP JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JOSEPH
Last Name:HEDGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 TAMPA RD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3312
Mailing Address - Country:US
Mailing Address - Phone:727-786-1631
Mailing Address - Fax:
Practice Address - Street 1:8740 MITCHELL BLVD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4400
Practice Address - Country:US
Practice Address - Phone:727-877-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 19081122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist