Individual
DR. MICHAEL ADDAIR TARVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1397 W LAKESHORE DR, CLERMONT, FL 34711-2939
(352) 404-5105
Mailing address
1397 W LAKESHORE DR, CLERMONT, FL 34711-2939
(863) 899-1617
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN18670
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002880000
—
FL
Enumeration date
07/01/2009
Last updated
03/31/2017
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