Provider Demographics
NPI:1952525008
Name:MAY, LINDA JUDY (DDS)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JUDY
Last Name:MAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-5202
Mailing Address - Country:US
Mailing Address - Phone:863-533-0324
Mailing Address - Fax:863-533-2751
Practice Address - Street 1:1495 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-5202
Practice Address - Country:US
Practice Address - Phone:863-533-0324
Practice Address - Fax:863-533-2751
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN105691223G0001X
WV28441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0752444Medicaid