Organization
APD - TACACHALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON E THOMAS (SUPERINTENDENT)
(352) 955-5856
Entity
Organization
Contact information
Practice address
1621 NE WALDO RD, GAINESVILLE, FL 32609-3900
(352) 955-5616
Mailing address
1621 NE WALDO RD, GAINESVILLE, FL 32609-3900
(352) 955-5668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN8807
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
681084596
—
FL
Enumeration date
01/26/2009
Last updated
03/26/2009
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