Provider Demographics
NPI:1790815355
Name:TROXLER, THOMAS C (D DS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:TROXLER
Suffix:
Gender:M
Credentials:D DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 9TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-1704
Mailing Address - Country:US
Mailing Address - Phone:941-747-5597
Mailing Address - Fax:941-749-0962
Practice Address - Street 1:3914 9TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-1704
Practice Address - Country:US
Practice Address - Phone:941-747-5597
Practice Address - Fax:941-749-0962
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00053571223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT84592Medicare UPIN