Provider Demographics
NPI:1730285891
Name:ED TONY FRANCISCO DDS PA
Entity Type:Organization
Organization Name:ED TONY FRANCISCO DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCISCO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-251-4432
Mailing Address - Street 1:2210 S MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5917
Mailing Address - Country:US
Mailing Address - Phone:813-251-4432
Mailing Address - Fax:813-259-9443
Practice Address - Street 1:2210 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5917
Practice Address - Country:US
Practice Address - Phone:813-251-4432
Practice Address - Fax:813-259-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty