Provider Demographics
NPI:1487474342
Name:TDN DENTISTRY, PLLC
Entity type:Organization
Organization Name:TDN DENTISTRY, PLLC
Other - Org Name:
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:813-692-2200
Mailing Address - Fax:
Practice Address - Street 1:200 N TAMIAMI TRL STE F
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-1914
Practice Address - Country:US
Practice Address - Phone:941-927-4308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TDN DENTISTRY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty