Provider Demographics
NPI:1023510344
Name:GEEDO DENTAL PLLC
Entity type:Organization
Organization Name:GEEDO DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGIED
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHARA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-744-2036
Mailing Address - Street 1:10330 N DALE MABRY HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4404
Mailing Address - Country:US
Mailing Address - Phone:813-749-4170
Mailing Address - Fax:813-354-2418
Practice Address - Street 1:10330 N DALE MABRY HWY STE 150
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4404
Practice Address - Country:US
Practice Address - Phone:813-749-4170
Practice Address - Fax:813-354-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN204141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty