Provider Demographics
NPI:1841817988
Name:WARD, POLLY (RDH)
Entity type:Individual
Prefix:
First Name:POLLY
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 MAIN ST STE P
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5225
Mailing Address - Country:US
Mailing Address - Phone:727-215-8057
Mailing Address - Fax:727-733-2753
Practice Address - Street 1:1022 MAIN ST STE P
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5225
Practice Address - Country:US
Practice Address - Phone:727-733-7848
Practice Address - Fax:727-733-2753
Is Sole Proprietor?:No
Enumeration Date:2020-07-04
Last Update Date:2020-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH14961124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist