Provider Demographics
NPI:1699008821
Name:GIUNTA, MATTHEW ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ANTHONY
Last Name:GIUNTA
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 1:4302 N HABANA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6367
Mailing Address - Country:US
Mailing Address - Phone:813-875-9367
Mailing Address - Fax:813-875-9458
Practice Address - Street 1:4302 N HABANA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6367
Practice Address - Country:US
Practice Address - Phone:813-875-9367
Practice Address - Fax:813-875-9458
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN188411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice