Provider Demographics
NPI:1407454960
Name:PETER TSAMBAZIS DMD, P.A.
Entity type:Organization
Organization Name:PETER TSAMBAZIS DMD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:TSAMBAZIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:917-692-3160
Mailing Address - Street 1:26670 ROSEWOOD POINTE CIR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7534
Mailing Address - Country:US
Mailing Address - Phone:917-692-3160
Mailing Address - Fax:
Practice Address - Street 1:6654 COLLIER BLVD UNIT 104
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-8179
Practice Address - Country:US
Practice Address - Phone:917-692-3160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty