Individual
DR. DOUGLAS G. GENNINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1305 W FLETCHER AVE, TAMPA, FL 33612-3310
(813) 968-4808
(813) 968-3439
Mailing address
19114 AVENUE BAYONNES, LUTZ, FL 33558-5358
(813) 949-2234
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9851
FL
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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