Provider Demographics
NPI:1679696561
Name:IMPLANT-TECH, INC.
Entity Type:Organization
Organization Name:IMPLANT-TECH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RATERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-760-4576
Mailing Address - Street 1:12006 HOPE LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3722
Mailing Address - Country:US
Mailing Address - Phone:813-760-4576
Mailing Address - Fax:
Practice Address - Street 1:12006 HOPE LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3722
Practice Address - Country:US
Practice Address - Phone:813-760-4576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies