Provider Demographics
NPI:1134946353
Name:TDN DENTISTRY, PLLC
Entity type:Organization
Organization Name:TDN DENTISTRY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSCARO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-692-2205
Mailing Address - Street 1:1 N DALE MABRY HWY STE 605
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2781
Mailing Address - Country:US
Mailing Address - Phone:813-692-2205
Mailing Address - Fax:813-692-2205
Practice Address - Street 1:1355 37TH ST STE 401
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7322
Practice Address - Country:US
Practice Address - Phone:772-569-9700
Practice Address - Fax:772-569-9704
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TDN DENTISTRY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty