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EDWARD S MORTELLARO JR DMD PA NPI 1770700437


NPI Information

NPI: 1770700437
Provider Name: EDWARD S MORTELLARO JR DMD PA
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
710 OAKFIELD DRIVE
SUITE 126
BRANDON, FL
ZIP 33511
Phone: (813) 685-7733
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EDWARD S MORTELLARO JR DMD PA is a periodontics dentist in Brandon, FL. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. EDWARD S MORTELLARO JR DMD PA NPI is 1770700437. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

710 OAKFIELD DRIVE
SUITE 126
BRANDON, FL
ZIP 33511-907
Phone: (813) 685-7733
Fax: (813) 681-9726

The provider's authorized official is Edward S Mortellaro .
The authorized official title is President and has the following contact phone number (813) 685-7733.

The enumeration date for this NPI number is 4/20/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0300XDentistPeriodonticsDN8061FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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