Provider Demographics
NPI:1952664633
Name:MICHAEL P. DIMAURO D.D.S., P.A.
Entity Type:Organization
Organization Name:MICHAEL P. DIMAURO D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KLINGBEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-352-4800
Mailing Address - Street 1:7424 DOCS GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8010
Mailing Address - Country:US
Mailing Address - Phone:407-352-4800
Mailing Address - Fax:407-352-8008
Practice Address - Street 1:7424 DOCS GROVE CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8010
Practice Address - Country:US
Practice Address - Phone:407-352-4800
Practice Address - Fax:407-352-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00119601223P0221X
FLDN173801223P0221X
FLDN187111223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty